Basic Information
Provider Information
NPI: 1669766184
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWNSON
FirstName: KIRSTYN
MiddleName: ELIZABETH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 20 YORK ST
Address2: YNHH - DEPT OF SURGERY
City: NEW HAVEN
State: CT
PostalCode: 065103220
CountryCode: US
TelephoneNumber: 2036884242
FaxNumber:  
Practice Location
Address1: 20 YORK ST
Address2: YNHH - DEPT OF SURGERY
City: NEW HAVEN
State: CT
PostalCode: 065103220
CountryCode: US
TelephoneNumber: 2036884242
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/01/2011
LastUpdateDate: 11/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
208600000X11354879-1205UTY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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