Basic Information
Provider Information
NPI: 1619460581
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRINGER
FirstName: BRYAN
MiddleName: F
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: UCONN SCHOOL OF MEDICINE
Address2: 263 FARMINGTON AVE
City: FARMINGTON
State: CT
PostalCode: 060301921
CountryCode: US
TelephoneNumber: 8606794763
FaxNumber: 8606794624
Practice Location
Address1: 79 RETREAT AVE.
Address2: HH-ADULT PRIMARY CARE - BROWN STONE
City: HARTFORD
State: CT
PostalCode: 06106
CountryCode: US
TelephoneNumber: 8609720200
FaxNumber: 8605453149
Other Information
ProviderEnumerationDate: 06/14/2018
LastUpdateDate: 07/10/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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