Brandon Ito, PA-C
Physician Assistant in Meriden, CT. Individual provider (NPI-1).
NPI number1962022129
StatusActive
Last updated in NPPESOct 27, 2021
Details
- NPI
- 1962022129
- Entity type
- Individual (NPI-1)
- Name
- Brandon Ito
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 17, 2020
- Certification date
- Oct 27, 2021
- Last updated
- Oct 27, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 5422 | CT | Yes |
Practice location
455 Lewis Ave Ste 221Meriden, CT 06451-2121
Phone 203-694-8550 · Fax 203-694-7698
Mailing address
1290 Silas Deane HwyHartford Healthcare-Cvo
Wethersfield, CT 06109-4337
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All 39 Physician Assistant providers in Meriden · All 1,158 providers in Meriden
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