Individual
DR. LARRY B. BROISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 KENSINGTON AVE, NEW BRITAIN, CT 06051-3916
(860) 832-8150
(860) 224-6298
Mailing address
300 KENSINGTON AVE, NEW BRITAIN, CT 06051-3916
(860) 832-8150
(860) 224-6298
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
022071
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010022071CT02
BCBS & BCFP PROVIDER ID
CT
01
—
01322071
CIGNA PROVIDER ID
CT
01
—
050648
CONNECTICARE
CT
01
—
060103
HEALTH NET PROVIDER ID
CT
01
—
1255448155
GHMC GROUP NPI PROVIDER I
CT
01
—
135713
WELLCARE MEDICARE
CT
01
—
511575
AETNA
CT
01
—
C01373
GHMC GROUP MEDICARE ID
CT
01
—
P369844
OXFORD PROVIDER ID
CT
Enumeration date
06/01/2005
Last updated
07/10/2007
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