Basic Information
Provider Information
NPI: 1407218001
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FARRAND
FirstName: BRIANNA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 69 SAND PIT RD
Address2: SUITE 300
City: DANBURY
State: CT
PostalCode: 068104004
CountryCode: US
TelephoneNumber: 2037482551
FaxNumber: 2037906375
Practice Location
Address1: 69 SAND PIT RD
Address2: SUITE 300
City: DANBURY
State: CT
PostalCode: 068104004
CountryCode: US
TelephoneNumber: 2037482551
FaxNumber: 2037906375
Other Information
ProviderEnumerationDate: 03/23/2016
LastUpdateDate: 03/23/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
133V00000X1386CTY Dietary & Nutritional Service ProvidersDietitian, Registered 

No ID Information.


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