Basic Information
| Provider Information | |||||||||
| NPI: | 1831338128 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BILBAO | ||||||||
| FirstName: | NORDIE | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 COLUMBUS BLVD FL 4 | ||||||||
| Address2: | |||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061061976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608375602 | ||||||||
| FaxNumber: | 8608375613 | ||||||||
| Practice Location | |||||||||
| Address1: | 505 FARMINGTON AVE STE 1S | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608376700 | ||||||||
| FaxNumber: | 8608376765 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2009 | ||||||||
| LastUpdateDate: | 04/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 33693 | AL | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0205X | 33693 | AL | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Endocrinology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2080P0205X | 61356 | CT | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Endocrinology |
No ID Information.