Michael C Antonellis
Physician Assistant in Bridgeport, Connecticut
1548930936- Practice location
- 2800 Main Street Dept Of Surgery, Bridgeport, CT 06606
- Phone
- 475-210-6512
- Fax
- —
- Last updated
- July 20, 2026
Michael Constantine Antonellis is a Physician Assistant based in Bridgeport, CT. Michael Constantine Antonellis practices in Bridgeport, CT. The NPI Number for Michael Constantine Antonellis is 1548930936 and holds a License No. 6627 (CT). The current practice location address for Michael Constantine Antonellis is 2800 Main Street Dept Of Surgery, Bridgeport, CT 06606 and can be reached out via phone at 475-210-6512.
Provider Profile Details
- NPI Number
- 1548930936
- Provider Name
- Michael Constantine Antonellis
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 2800 Main Street Dept Of Surgery, Bridgeport, CT 06606
- Phone Number
- 475-210-6512
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- September 16, 2021
- Last Update Date
- July 20, 2026
- Certification Date
- July 20, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 2800 Main Street Dept Of Surgery
Bridgeport, CT 06606 - City
- Bridgeport
- State
- Connecticut
- Zip
- 06606
- Phone Number
- 475-210-6512
Provider Business Mailing Address Details
- Address
- 1290 Silas Deane Hwy
Wethersfield, CT 06109-4337 - City
- Wethersfield
- State
- CT
- Zip
- 06109-4337
- Phone Number
- 203-909-4171
License Information
- Taxonomy (1)
- Physician Assistant · 363A00000X
- License Number (2)
- 6627
- License State (2)
- CT
- Taxonomy (2)
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Michael C Antonellis?
The NPI number of Michael C Antonellis is 1548930936. It was assigned on September 16, 2021 and is currently active in the NPPES registry.
What is the specialty of Michael C Antonellis?
Michael C Antonellis is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in CT under license number 6627.
Where does Michael C Antonellis practice?
The practice location is 2800 Main Street Dept Of Surgery, Bridgeport, CT 06606. The office can be reached at 475-210-6512 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1548930936 directly on the NPPES registry website.