Basic Information
| Provider Information | |||||||||
| NPI: | 1053402263 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | ANDREW | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 672 SILAS DEANE HWY | ||||||||
| Address2: | |||||||||
| City: | WETHERSFIELD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061093053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8609673600 | ||||||||
| FaxNumber: | 8609673610 | ||||||||
| Practice Location | |||||||||
| Address1: | 672 SILAS DEANE HWY | ||||||||
| Address2: | KATHY'S URGENT CARE OF WETHERSFIELD | ||||||||
| City: | WETHERSFIELD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061093053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8609673600 | ||||||||
| FaxNumber: | 8609673610 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2006 | ||||||||
| LastUpdateDate: | 08/06/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | RT1377 | NH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 045352 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.