Individual
BRONSON E TERRY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 POMFRET ST, PUTNAM, CT 06260-1836
(860) 963-6390
(860) 963-6343
Mailing address
320 POMFRET ST, PUTNAM, CT 06260-1836
(860) 963-6390
(860) 963-6343
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
043624
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043624
CONNECTICARE
CT
Enumeration date
10/10/2005
Last updated
07/08/2007
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