Provider Demographics
NPI:1578613964
Name:MUNDAY, BRIAN PATRICK (PA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:PATRICK
Last Name:MUNDAY
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Gender:M
Credentials:PA
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Mailing Address - Street 1:15 YORK ST YALE EPILEPSY CENTER
Mailing Address - Street 2:COMPREHENSIVE EPILEPSY CENTER LLCI 716
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8018
Mailing Address - Country:US
Mailing Address - Phone:203-785-3865
Mailing Address - Fax:203-737-2799
Practice Address - Street 1:800 HOWARD AVE LOWER LEVEL
Practice Address - Street 2:COMPREHENSIVE EPILEPSY CENTER LLCI 716
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06520-8018
Practice Address - Country:US
Practice Address - Phone:203-785-3865
Practice Address - Fax:203-737-2799
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2016-06-07
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Provider Licenses
StateLicense IDTaxonomies
CA18730363AM0700X
MAPA4176363AM0700X
CT2235363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical