Healthcare Provider Details

I. General information

NPI: 1790609766
Provider Name (Legal Business Name): AMORE PANTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 BROAD ST
BRIDGEPORT CT
06604-4812
US

IV. Provider business mailing address

610 CLARK ST
BRIDGEPORT CT
06606-3303
US

V. Phone/Fax

Practice location:
  • Phone: 203-502-3995
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: