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Contact Information

BRANDON TIBBITTS, PA-C
1290 SILAS DEANE HWY
WETHERSFIELD, CT06109-4337
 Phone: 860-777-1280
 Fax: 860-777-1276
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for BRANDON TIBBITTS · (Male)

NPI # 1205276474
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 07/02/2013
Last updated 10/10/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • CT License # 003752
Hospital affiliation(s)
  • BAYSTATE MEDICAL CENTER - (Acute Care)
    759 CHESTNUT STREET
    SPRINGFIELD, MA 01199
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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