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NPI Profile for Dr MARIA MIKOLAENKO in BRIDGEPORT, CT.
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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adult Medicine |
207QA0505X | 08 | Physician/Family Practice |
| NPI # | 1063824761 |
|
| Status | Active | |
| Credentials | DO (Doctor of Osteopathic) | |
| Entity | Individual | |
| Enumeration date | 05/29/2014 | |
| Last updated | 10/02/2020 - About 6 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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MARIA MIKOLAENKO
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MARIA MIKOLAENKO, DO