Provider Demographics
NPI:1649775214
Name:LAWSON, BRENDAN MCKAY (DO)
Entity Type:Individual
Prefix:
First Name:BRENDAN
Middle Name:MCKAY
Last Name:LAWSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3538
Mailing Address - Country:US
Mailing Address - Phone:203-878-1236
Mailing Address - Fax:203-874-8838
Practice Address - Street 1:202 CHERRY ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3538
Practice Address - Country:US
Practice Address - Phone:203-878-1236
Practice Address - Fax:203-874-8838
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA291595207W00000X
CT73437207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty