Individual
MR. BRIAN THOMAS MAURER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
155 HAZARD AVE, SUITE 14, ENFIELD, CT 06082-4580
(860) 749-3169
(860) 749-2670
Mailing address
19 MAPLE ST, TARIFFVILLE, CT 06081-9636
(860) 651-9940
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000073
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008036364
—
CT
Enumeration date
03/09/2006
Last updated
09/01/2013
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