Healthcare Provider Details

I. General information

NPI: 1932030137
Provider Name (Legal Business Name): MELISSA BROMELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MERRITT BLVD STE 25
TRUMBULL CT
06611-5450
US

IV. Provider business mailing address

558 WINTHROP AVE
NEW HAVEN CT
06511-3150
US

V. Phone/Fax

Practice location:
  • Phone: 888-754-0398
  • Fax:
Mailing address:
  • Phone: 475-331-8473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: