Healthcare Provider Details

I. General information

NPI: 1982159885
Provider Name (Legal Business Name): TOWN OF MONROE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2016
Last Update Date: 08/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 FAN HILL RD
MONROE CT
06468-1847
US

IV. Provider business mailing address

7 FAN HILL RD
MONROE CT
06468-1847
US

V. Phone/Fax

Practice location:
  • Phone: 203-452-2818
  • Fax:
Mailing address:
  • Phone: 203-452-2818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NANCY CAROL BRAULT
Title or Position: DIRCTOR OF HEALTH
Credential: MPH
Phone: 203-452-2818