Provider Demographics
NPI:1487058707
Name:PATRICK BREW RN
Entity type:Organization
Organization Name:PATRICK BREW RN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BREW
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:203-244-9529
Mailing Address - Street 1:PO BOX 266
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:CT
Mailing Address - Zip Code:06752-0266
Mailing Address - Country:US
Mailing Address - Phone:203-244-9529
Mailing Address - Fax:203-648-4172
Practice Address - Street 1:246 FEDERAL RD STE D22
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2650
Practice Address - Country:US
Practice Address - Phone:203-244-9529
Practice Address - Fax:203-648-4172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005758363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty