Provider Demographics
NPI:1669675476
Name:FLEIT, BROOKE (CPNP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:FLEIT
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ORCHARD ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5363
Mailing Address - Country:US
Mailing Address - Phone:203-865-3737
Mailing Address - Fax:203-624-0751
Practice Address - Street 1:200 ORCHARD ST
Practice Address - Street 2:SUITE 108
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5363
Practice Address - Country:US
Practice Address - Phone:203-865-3737
Practice Address - Fax:203-624-0751
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003804363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics