Individual
BRIAN P WEBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
55 HAZARD AVE, ENFIELD, CT 06082-3826
(860) 745-9911
Mailing address
1716 WALLACE ST APT 202, PHILADELPHIA, PA 19130-4302
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
6032
CT
Other
Enumeration date
12/02/2014
Last updated
11/06/2024
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