Braddock, Jenny M
Braddock, Jenny M is an individual health care provider with primary practice located at 117 Sharon Rd Mall View Plaza, Waterbury CT 06705-4000. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Braddock, Jenny M can be contacted via phone (203) 756-2334.Contact Information
Primary practice address
117 Sharon Rd Mall View Plaza
Waterbury CT 06705-4000
Phone: (203) 756-2334
Fax: (203) 756-2594
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 007053 | Connecticut |
Profile Details
| NPI number | 1558430785 |
|---|---|
| LBN Legal business name | Braddock, Jenny M |
| Credentials | PT, OCS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 6th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558430785 | NPPES |
| Connecticut | Other | 080007053CT01 | BCBS PROVIDER NUMBER |
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