Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 63926 | CT |
N | 111NI0900X | Internist | 63926 | CT |
Y | 207RI0200X | Infectious Disease | 63926 | CT |
NPI | 1043635477 |
---|---|
Provider Name | Yardley Brice |
First Address | New London, CT 06320 |
Second Address | New London, CT 06320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2014 |
Last Update Date | 27/01/2021 |