Individual provider · Type 1 NPI
Shanice Nicole Brucelis
Adult Medicine Physician · Enfield, CT
NPI number
1164372280
Active
Practice location
38 Glenwood St
Enfield, CT 06082-2715
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Medicine Physician Primary | 207QA0505X | 171673 (CT) |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
About NPI 1164372280
Shanice Nicole Brucelis's National Provider Identifier is 1164372280, issued on Jan 29, 2026. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Enfield, CT. The record was last updated on Jan 29, 2026.