Individual
MR. BRADLEY G. BISKUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-3343
(860) 679-4256
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1816
CT
Other
Enumeration date
10/05/2006
Last updated
09/26/2022
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