Brandon Lillard, BA

Individual provider Active NPI Case Manager/Care Coordinator · Waterbury, CT

NPI 1962882324 · NPPES record last updated Jun 1, 2015

Key facts

NPI
1962882324
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
402 E Main St
Waterbury, CT 06702-1701
Phone
(203) 755-1143
Fax
(203) 753-3274
NPI assigned
Jun 1, 2015
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Arts

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

402 E Main St
Waterbury, CT 06702-1701

Mailing address

141 E Main St
4TH Floor Administration
Waterbury, CT 06702-2310
Phone (203) 574-9000

Other providers in Waterbury, CT

All providers in Waterbury, CT · Case Manager/Care Coordinator in Connecticut

Sources for this page

Verify at the official NPI Registry.