Individual
DR. PETER J. BRANDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1201 W MAIN ST, SUITE 100, WATERBURY, CT 06708-3105
(203) 597-9100
(203) 596-4758
Mailing address
1201 W MAIN ST, SUITE 100, WATERBURY, CT 06708-3105
(203) 597-9100
(203) 401-6517
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
031640
CT
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
31640
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180000516
MEDICARE PTAN
CT
Enumeration date
02/02/2006
Last updated
06/26/2024
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