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General NPI Number Information
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NPI Number | 1881618890
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Entity Type | Individual
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Provider Name | GLENN BRADY MD.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 365 MONTAUK AVE
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City | NEW LONDON
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State | CT
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Zip | 06320-4700
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Country | US
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Telephone | 860-886-3372
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Fax | 475-246-9503
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Provider Business Mailing Address
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Address Line | LAWRENCE AND MEMORIAL HOSPITAL DEPT OF ANESTHESIA 365 MONTAUK AVE
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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 | 860-886-3372
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Fax | 475-246-9503
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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 | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 044060
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 044060
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 252651
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 16786
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License Number State | RI
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Taxonomy #5
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 252651
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License Number State | NY
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