Cassamajor, Kettly
Cassamajor, Kettly is an sole proprietor health care provider with primary practice located at 4920 Main St Ste 302 , Bridgeport CT 06606-1300. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Cassamajor, Kettly can be contacted via phone (475) 210-4960.Contact Information
Primary practice address
4920 Main St Ste 302
Bridgeport CT 06606-1300
Phone: (475) 210-4960
Fax: (203) 371-0542
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 12.006973 | Connecticut |
Profile Details
| NPI number | 1235660267 |
|---|---|
| LBN Legal business name | Cassamajor, Kettly |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 22nd, 2017 |
| Last updated | Mar 9th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235660267 | NPPES |
| Connecticut | MEDICAID | 004234788 |
Popular Providers
-
Dubose-Cooper, Sheila
982 E Main St Optimus Health Care- School-Based Health Centers, Bridgeport CT 06608-1913 -
Croll, Diane Rose
600 Bond St , Bridgeport CT 06610-2205 -
Madden, Lindsey
2800 Main St , Bridgeport CT 06606-4201 -
Goode, Kelly C.
2800 Main St , Bridgeport CT 06606-4201 -
Philipose, Jyothy
2800 Main Street St..Vincent'S Medical Center, Bridgeport CT 06606 -
Stern, Logan
46 Albion St , Bridgeport CT 06605-2602 -
Neubig, Sandra
2800 Main St Hospitalist Department, Bridgeport CT 06606-4201 -
Sbrega, Michele A
46 Albion St , Bridgeport CT 06605-2602