Brookfield Preventive Medicine, LLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001466 Issued in CT

Legal business name

BROOKFIELD PREVENTIVE MEDICINE, LLC

Practice address

300 Federal Rd
Building 1, Suite 100
Brookfield, CT 06804-2412

Phone

(203) 740-7500

NPI assigned

Jan 31, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Eugenia Ann Corriero, PA-CNPI 1639216427

Title

Member

Phone

(203) 740-7500

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eugenia Ann Corriero, PA-C

  • Medical Physician Assistant
  • Brookfield, CT
  • NPI 1639216427
  NPD (past) Authorized official
• David L Johnston, DO

  • General Practice Physician
  • Ridgefield, CT
  • NPI 1245212471
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740327543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FEDERAL RD",
            "address_2": "BUILDING 1, SUITE 100",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042412",
            "telephone_number": "203-740-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FEDERAL RD",
            "address_2": "BUILDING 1, SUITE 100",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042412",
            "telephone_number": "203-740-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKFIELD PREVENTIVE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CORRIERO",
        "authorized_official_first_name": "EUGENIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "203-740-7500",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brookfield Medical/Surgical Supplies Inc. (Brookfield Pharmacy)
• Brookfield Medical/Surgical Supplies, Inc. (Brookfield Pharmacy)
• Brookfield Orthodontics
• Brookfield Pediatric Dental LLC
• Brookfield Podiatry
• Brookfield Primary Care, LLC
• Brookfield Public Schools
• Brookfield Speech and Language, LLC
• Brookfield Vision Care, LLC
• Brookfieldfamilydentalart

• Medical Physician Assistant in Brookfield, CT
• Providers in Brookfield, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.