Healthcare Provider Details

I. General information

NPI: 1265395040
Provider Name (Legal Business Name): EMILY GAMMILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 FRANKLIN ST
WATERBURY CT
06706-1253
US

IV. Provider business mailing address

630 CHAPEL ST APT 240
NEW HAVEN CT
06510-3167
US

V. Phone/Fax

Practice location:
  • Phone: 203-709-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835I0206X
TaxonomyInfectious Diseases Pharmacist
License NumberPCT.0016733
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: