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General NPI Number Information
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NPI Number | 1669460176
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Entity Type | Individual
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Provider Name | JAMES JOSEPH BRAKONIECKI M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 01/28/2014
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Provider Practice Location Address
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Address Line | 99 E RIVER DR #300 C/O IPMS
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City | EAST HARTFORD
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State | CT
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Zip | 06108-3288
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Country | US
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Telephone | 860-282-4137
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Fax | 860-289-0742
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Provider Business Mailing Address
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Address Line | 99 E RIVER DR #300 C/O IPMS
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City | EAST HARTFORD
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State | CT
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Zip | 06108-3288
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Country | US
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Telephone | 860-282-4137
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Fax | 860-289-0742
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 026301
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License Number State | CT
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