Provider Demographics
NPI:1104375633
Name:BRAUNE, MARIA C (PA-C)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:C
Last Name:BRAUNE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BLACHLEY ROAD
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-0003
Mailing Address - Country:US
Mailing Address - Phone:203-276-2277
Mailing Address - Fax:203-276-2278
Practice Address - Street 1:1 BLACHLEY ROAD
Practice Address - Street 2:FLOOR 2
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-0003
Practice Address - Country:US
Practice Address - Phone:203-276-2277
Practice Address - Fax:203-276-2278
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY020167363A00000X
CT363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant