Healthcare Provider Details

I. General information

NPI: 1720775943
Provider Name (Legal Business Name): PRANITA PAUDYAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 GRANT ST
BRIDGEPORT CT
06610-2870
US

IV. Provider business mailing address

267 GRANT ST
BRIDGEPORT CT
06610-2805
US

V. Phone/Fax

Practice location:
  • Phone: 203-384-3446
  • Fax:
Mailing address:
  • Phone: 203-384-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number86073
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: