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DR. EVAN LED BISHOP PHARMD

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1174975197

Individual Registrant:
DR. EVAN LED BISHOP PHARMD
Gender: M
Sole Proprietor

Location and contact information for practice:
148 EASTERN BLVD 4TH FLOOR GLASTONBURY, CT 06033-4321 US
Tel: 860-657-9384  Fax: --

Contact information for business:
21 MONTOWESE AVE  NORTH HAVEN, CT 06473-3616 US
Tel: --  Fax: --

Registration Information:
NPI: 1174975197
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
CTPCT.0013718

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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