NPI 1063990612 · live from the CMS NPI Registry
Dana Brunell Eisenberg
Nurse Practitioner, Pediatrics in Bridgeport, CT. National Provider Identifier 1063990612, active.
NPI record
| NPI | 1063990612 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 46 Albion St, Bridgeport, CT 06605 |
| Practice phone | 203-330-6000 |
| Mailing address | 140 Dixon St, Bridgeport, CT 06604 |
| Enumerated | August 4, 2018 |
| Last updated | February 13, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Community Health | 163WC1500X | 136714 (CT) |
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 7799 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.