Marquis-Eydman, Traci J
Marquis-Eydman, Traci J is an individual health care provider with primary practice located at 2979 Main St , Bridgeport CT 06606-4284. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Marquis-Eydman, Traci J can be contacted via phone (203) 382-2345.Contact Information
Primary practice address
2979 Main St
Bridgeport CT 06606-4284
Phone: (203) 382-2345
Fax: (860) 358-6748
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 039190 | Connecticut |
Profile Details
| NPI number | 1578591780 |
|---|---|
| LBN Legal business name | Marquis-Eydman, Traci J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Aug 14th, 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 | 1578591780 | NPPES |
| Connecticut | MEDICAID | 001391903 |
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