Healthcare Provider Details

I. General information

NPI: 1689785479
Provider Name (Legal Business Name): BRIDGET J HURD PHARM.D,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 WILLARD AVE VA CT HEALTHCARE SYSTEM- ATTN: PHARMACY DEPARTMENT
NEWINGTON CT
06111-2631
US

IV. Provider business mailing address

25 WINDY HILL LN
ROCKY HILL CT
06067-2865
US

V. Phone/Fax

Practice location:
  • Phone: 860-666-6951
  • Fax:
Mailing address:
  • Phone: 860-436-2333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number9761
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: