MEDICARE: BRIDGEPORT HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	0040	CT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	C00020	OTHER		FIRSTCOAST MEDICAREPARTB

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	07D0099572	OTHER	CLIA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649260845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIDGEPORT HOSPITAL

Provider Business Mailing Address
First Line	:	267 GRANT ST
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06610-2805
Country	:	US
Telephone Number	:	203-384-3775
Fax Number	:

Provider Business Practice Location Address
First Line	:	267 GRANT ST
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06610-2805
Country	:	US
Telephone Number	:	203-384-3775
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JACQUELINE WRINN
Credential	:
Telephone Number	:	203-688-8411

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	11/06/2025

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1871589242 — ALAN KAYE MD
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1669454914 — MARGUERITE M PINTO MD
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1245212596 — YOUNG CHOI KIM MD
Practice Location Address:

267 GRANT ST
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06610-2805

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Directions to “BRIDGEPORT HOSPITAL ” Practice Location

Language	Start Address	Practice Location

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