Healthcare Provider Details

I. General information

NPI: 1235052689
Provider Name (Legal Business Name): BRIAN F WALSH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

2150 CORBIN AVE
NEW BRITAIN CT
06053-2266
US

IV. Provider business mailing address

2150 CORBIN AVE
NEW BRITAIN CT
06053-2266
US

V. Phone/Fax

Practice location:
  • Phone: 860-505-5336
  • Fax:
Mailing address:
  • Phone: 860-505-5336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number08591
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License Number08591
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number08591
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: