Provider Demographics
NPI:1669454914
Name:PINTO, MARGUERITE M (MD)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:M
Last Name:PINTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:267 GRANT ST
Mailing Address - Street 2:BRIDGEPORT HOSPITAL, DEPT. OF PATHOLOGY
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610-2805
Mailing Address - Country:US
Mailing Address - Phone:203-384-3157
Mailing Address - Fax:203-384-3237
Practice Address - Street 1:267 GRANT ST
Practice Address - Street 2:BRIDGEPORT HOSPITAL, DEPT. OF PATHOLOGY
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-2805
Practice Address - Country:US
Practice Address - Phone:203-384-3157
Practice Address - Fax:203-384-3237
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT018613207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001186139Medicaid
CT220000584Medicare ID - Type Unspecified
CT001186139Medicaid