Provider Demographics
NPI:1366999856
Name:FAUST, BRIANNA (PA-C)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:FAUST
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2259 BURGUNDY DR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8772
Mailing Address - Country:US
Mailing Address - Phone:484-350-9756
Mailing Address - Fax:
Practice Address - Street 1:1 HOSPITAL PLAZA
Practice Address - Street 2:STAMFORD HOSPITAL - EMERGENCY DEPARTMENT
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902
Practice Address - Country:US
Practice Address - Phone:203-276-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical