Healthcare Provider Details

I. General information

NPI: 1760968598
Provider Name (Legal Business Name): MONITOR MY HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2018
Last Update Date: 11/27/2023
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 LAFAYETTE BLVD STE 1100
BRIDGEPORT CT
06604-4710
US

IV. Provider business mailing address

1000 LAFAYETTE BLVD STE 1100
BRIDGEPORT CT
06604-4710
US

V. Phone/Fax

Practice location:
  • Phone: 203-683-5946
  • Fax: 203-683-5901
Mailing address:
  • Phone: 203-683-5946
  • Fax: 203-683-5901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. DANA PARIS WADE
Title or Position: CEO
Credential: MD
Phone: 203-394-7311