Healthcare Provider Details

I. General information

NPI: 1528995263
Provider Name (Legal Business Name): GILBERTO ALEJANDRO LORA CASTELLANOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 MAIN STREET DEPARTMENT OF MEDICAL EDUCATION
BRIDGEPORT CT
06606-4201
US

IV. Provider business mailing address

2800 MAIN STREET DEPARTMENT OF MEDICAL EDUCATION
BRIDGEPORT CT
06606-4201
US

V. Phone/Fax

Practice location:
  • Phone: 203-576-6000
  • Fax: 475-210-5022
Mailing address:
  • Phone: 203-576-6000
  • Fax: 475-210-5022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: