Healthcare Provider Details

I. General information

NPI: 1710918032
Provider Name (Legal Business Name): DEBRA SCHWAB BRANDT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 KENNEDY DR
TORRINGTON CT
06790-3096
US

IV. Provider business mailing address

200 KENNEDY DR
TORRINGTON CT
06790-3096
US

V. Phone/Fax

Practice location:
  • Phone: 860-482-5384
  • Fax: 860-496-4951
Mailing address:
  • Phone: 860-482-5384
  • Fax: 860-489-1799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number000418
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: