Peck, Brian
Peck, Brian is an sole proprietor health care provider with primary practice located at 1389 W Main St Suite 120, Waterbury CT 06708-3104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as his primary health care specialty. Peck, Brian can be contacted via phone (203) 755-5555.Contact Information
Primary practice address
1389 W Main St Suite 120
Waterbury CT 06708-3104
Phone: (203) 755-5555
Fax: (203) 573-8523
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 016893 | Connecticut |
Profile Details
| NPI number | 1629036868 |
|---|---|
| LBN Legal business name | Peck, Brian |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 3rd, 2006 |
| Last updated | Dec 15th, 2020 - about 5 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 | 1629036868 | NPPES |
| Connecticut | MEDICAID | 004085636 |
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