Provider Demographics
NPI:1336478478
Name:BRIDGPORT HOSPITAL
Entity Type:Organization
Organization Name:BRIDGPORT HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENCY COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOSSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-384-3834
Mailing Address - Street 1:125 PROSPECT ST APT 6A
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-1220
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:267 GRANT ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-2805
Practice Address - Country:US
Practice Address - Phone:203-384-3834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital