Individual
BRANDON ITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
455 LEWIS AVE STE 221, MERIDEN, CT 06451-2121
(203) 694-8550
(203) 694-7698
Mailing address
1290 SILAS DEANE HWY, HARTFORD HEALTHCARE-CVO, WETHERSFIELD, CT 06109-4337
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5422
CT
Other
Enumeration date
04/17/2020
Last updated
10/27/2021
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