Individual
MARISA ANNE BROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
435 LEWIS AVE, MERIDEN, CT 06451-2101
(833) 286-7846
Mailing address
435 LEWIS AVE, MERIDEN, CT 06451-2101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7836
CT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
CT
Other
Enumeration date
06/11/2026
Last updated
06/18/2026
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