Provider Demographics
NPI:1245577998
Name:CONNER, BRIAN PATRICK (DC, CNS, CDN)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:PATRICK
Last Name:CONNER
Suffix:
Gender:M
Credentials:DC, CNS, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 FEDERAL RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2406
Mailing Address - Country:US
Mailing Address - Phone:203-775-1819
Mailing Address - Fax:203-775-2028
Practice Address - Street 1:366 FEDERAL RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2406
Practice Address - Country:US
Practice Address - Phone:203-775-1819
Practice Address - Fax:203-775-2028
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1485133N00000X
CT1931111N00000X
NY012297111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No133N00000XDietary & Nutritional Service ProvidersNutritionist