Healthcare Provider Details

I. General information

NPI: 1083528301
Provider Name (Legal Business Name): AMY XU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 MAIN ST
FARMINGTON CT
06032-2961
US

IV. Provider business mailing address

330 MAIN ST
FARMINGTON CT
06032-2961
US

V. Phone/Fax

Practice location:
  • Phone: 860-677-5047
  • Fax: 860-674-9995
Mailing address:
  • Phone: 860-677-5047
  • Fax: 860-674-9995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0017459
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: