Provider Demographics
NPI:1659699460
Name:BROPHY, JOSEPH PETER (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PETER
Last Name:BROPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WOODRUFF ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-3320
Mailing Address - Country:US
Mailing Address - Phone:864-337-4233
Mailing Address - Fax:864-797-6198
Practice Address - Street 1:816 BROAD ST
Practice Address - Street 2:SUITE 24
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-4350
Practice Address - Country:US
Practice Address - Phone:203-238-1919
Practice Address - Fax:203-238-1922
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC32551207Q00000X
CT54678207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine