| Organization Name: | 1271972 LLC |
| NPI Number: | 1316326002 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS A BROWN (MD/OWNER) |
| Mailing Address: | 672 Silas Deane Hwy Wethersfield |
| State: | CT US |
| Postal Code: | 061093053 |
| Phone Number: | 8609673600 |
| Fax Number: | 8609673610 |
| NPI Enumeration Date: | 05/27/2015 |
| NPI Last Update Date: | 06/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |