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General NPI Number Information
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NPI Number | 1720550445
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Entity Type | Organization
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Legal Business Name | DEBORAH BRUNSON MD LLC
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Dates
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Enumeration Date | 12/19/2018
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Last Update Date | 12/19/2018
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Provider Practice Location Address
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Address Line | 234 BROAD ST STE 12044
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City | MILFORD
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State | CT
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Zip | 06460-3278
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Country | US
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Telephone | 203-877-3728
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Fax | 203-877-1614
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Provider Business Mailing Address
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Address Line | 234 BROAD ST STE 1
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City | MILFORD
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State | CT
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Zip | 06460-3278
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Country | US
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Telephone | 203-877-3728
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Fax | 203-877-1614
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Authorized Official
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Title or Position | BILLING
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Name | TERRY CHOSZCZYK
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Credential |
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Telephone | 203-278-6394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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