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Individual

BROOKE ASHLEY HARNISCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
UCONN MEDICAL GROUP, 263 FARMINGTON AVENUE, FARMINGTON, CT 06030-0001
(860) 679-4100
(860) 679-1064
Mailing address
UCONN MEDICAL GROUP, 263 FARMINGTON AVENUE, FARMINGTON, CT 06030-0001
(860) 679-4100
(860) 679-1064

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
232874
MA
208800000X
Urology Physician
Primary
60198
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1528233988
WI
Enumeration date
04/28/2008
Last updated
09/26/2022
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