Healthcare Provider Details

I. General information

NPI: 1164185161
Provider Name (Legal Business Name): KAMIL BUDNIK PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2021
Last Update Date: 10/16/2021
Certification Date: 04/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 BERLIN TPKE
BERLIN CT
06037-1506
US

IV. Provider business mailing address

41 OVERLOOK AVE
NEW BRITAIN CT
06053-2301
US

V. Phone/Fax

Practice location:
  • Phone: 860-829-0800
  • Fax: 860-828-0862
Mailing address:
  • Phone: 860-357-7189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0015013
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: