Individual
LAURA CELESTE BRENES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
76 BATTERSON PARK RD STE 106, FARMINGTON, CT 06032-2571
(203) 228-2097
Mailing address
76 BATTERSON PARK RD STE 106, FARMINGTON, CT 06032-2571
(203) 228-2097
(203) 816-5564
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
046967
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174795371
—
CT
01
—
608892
WELLCARE
CT
01
—
9473362
AETNA
CT
01
—
P00964331
RAILROAD MEDICARE
CT
Enumeration date
03/27/2008
Last updated
02/04/2022
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