Healthcare Provider Details

I. General information

NPI: 1316260284
Provider Name (Legal Business Name): THERESA F PAINE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: THERESA F FAY PHARMD

II. Dates (important events)

Enumeration Date: 03/08/2010
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 COLUMBUS BLVD STE 901
HARTFORD CT
06103-1840
US

IV. Provider business mailing address

450 COLUMBUS BLVD STE 901
HARTFORD CT
06103-1840
US

V. Phone/Fax

Practice location:
  • Phone: 475-296-3609
  • Fax:
Mailing address:
  • Phone: 475-296-3609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9985
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: