Individual
SHAWN RICHARD BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
201 CHESTNUT HILL RD, STAFFORD SPRINGS, CT 06076-4005
(860) 684-8126
Mailing address
72 KINGFISHER CIR, SOUTH WINDSOR, CT 06074-4307
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2417
CT
Other
Enumeration date
07/21/2010
Last updated
07/21/2010
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