Individual
DR. JACQUELYN MICHELLE BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
32 STRAWBERRY HILL COURT, EAR, NOSE, AND THROAT CENTER, STAMFORD, CT 06902-2594
(203) 359-3533
(203) 357-8109
Mailing address
32 STRAWBERRY HILL COURT, EAR, NOSE, AND THROAT CENTER, STAMFORD, CT 06902-2594
(203) 359-3533
(203) 357-8109
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
049534
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP1-0026059
INSTITUTIONAL PERMIT
—
Enumeration date
06/09/2007
Last updated
10/19/2012
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