Provider Demographics
NPI:1245328509
Name:EMU, BRINDA (MD)
Entity type:Individual
Prefix:
First Name:BRINDA
Middle Name:
Last Name:EMU
Suffix:
Gender:F
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:PO BOX 208022
Mailing Address - Street 2:TAC S163
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8022
Mailing Address - Country:US
Mailing Address - Phone:203-785-4140
Mailing Address - Fax:203-785-3864
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-785-4140
Practice Address - Fax:203-785-3864
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80336207R00000X, 207RI0200X
CT051493207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A803360Medicaid
CA00A803360Medicaid
I28692Medicare UPIN