Provider Demographics
NPI:1518034016
Name:JOAO M.A. NASCIMENTO, M.D.
Entity Type:Organization
Organization Name:JOAO M.A. NASCIMENTO, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAO
Authorized Official - Middle Name:MA
Authorized Official - Last Name:NASCIMENTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-371-0009
Mailing Address - Street 1:3203 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-4225
Mailing Address - Country:US
Mailing Address - Phone:203-371-0009
Mailing Address - Fax:203-371-0091
Practice Address - Street 1:3203 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-4225
Practice Address - Country:US
Practice Address - Phone:203-371-0009
Practice Address - Fax:203-371-0091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT029415207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02607Medicare ID - Type Unspecified
CTD83635Medicare UPIN