Healthcare Provider Details

I. General information

NPI: 1326606690
Provider Name (Legal Business Name): BRIAN V MONAHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 MAPLE ST
NORWALK CT
06850
US

IV. Provider business mailing address

34 MAPLE ST
NORWALK CT
06850-3894
US

V. Phone/Fax

Practice location:
  • Phone: 203-852-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT217949
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number80590
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number80590
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: