Healthcare Provider Details

I. General information

NPI: 1245524032
Provider Name (Legal Business Name): SON H CAO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 06/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 FRANKLIN AVE
HARTFORD CT
06114-1851
US

IV. Provider business mailing address

108 WAVERLY DR
NEWINGTON CT
06111-4649
US

V. Phone/Fax

Practice location:
  • Phone: 860-296-3478
  • Fax: 860-296-3483
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8351
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: