Healthcare Provider Details

I. General information

NPI: 1790837227
Provider Name (Legal Business Name): BRIDGEPORT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 GRANT ST
BRIDGEPORT CT
06610-2805
US

IV. Provider business mailing address

267 GRANT ST
BRIDGEPORT CT
06610-2805
US

V. Phone/Fax

Practice location:
  • Phone: 203-384-3775
  • Fax:
Mailing address:
  • Phone: 203-384-3775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number040
License Number StateCT

VIII. Authorized Official

Name: JACQUELINE WRINN
Title or Position: DIRECTOR
Credential:
Phone: 203-688-8411