Provider Demographics
NPI:1457798522
Name:MESSINA, BRIDGET (MD,)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:MESSINA
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14212-1460
Mailing Address - Country:US
Mailing Address - Phone:716-323-0035
Mailing Address - Fax:
Practice Address - Street 1:1021 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14212-1460
Practice Address - Country:US
Practice Address - Phone:716-323-0035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283874208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics