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General NPI Number Information
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NPI Number | 1578214706
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Entity Type | Individual
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Provider Name | BRIANNA PERRY PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/10/2022
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 53 GRANITE STREET SUITE D
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City | NEW LONDON
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State | CT
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Zip | 06320
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Country | US
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Telephone | 860-447-1419
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Fax |
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Provider Business Mailing Address
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Address Line | 102 VALLEY RD
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City | MIDDLETOWN
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State | RI
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Zip | 02842-5237
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Country | US
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Telephone | 401-239-1800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 6398
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA01558
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License Number State | RI
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