Individual
BRIAN T GIRARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
20 YORK ST, YNHH TOMPKINS 2, RM 226, NEW HAVEN, CT 06510-3220
(203) 688-9503
Mailing address
20 YORK ST, YNHH TOMPKINS 2, RM 226, NEW HAVEN, CT 06510-3220
(203) 688-9503
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
55012
CT
2085R0202X
Diagnostic Radiology Physician
LT-3705
NH
363AM0700X
Medical Physician Assistant
001255
CT
363AS0400X
Surgical Physician Assistant
001255
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060911608
HMC
—
01
—
0R0365
HEALTHNET
—
01
—
290001255CT01
ANTHEM
—
01
—
51124
AIM
—
01
—
711609
CT CARE
—
01
—
87986
AETNA
—
01
—
A437740
OXFORD
—
Enumeration date
04/28/2006
Last updated
07/06/2016
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