Healthcare Provider Details

I. General information

NPI: 1942594981
Provider Name (Legal Business Name): JOSHUA D VALLEE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2011
Last Update Date: 06/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 ROUTE 85
WATERFORD CT
06385-4246
US

IV. Provider business mailing address

900 ROUTE 85
WATERFORD CT
06385-4246
US

V. Phone/Fax

Practice location:
  • Phone: 860-443-3171
  • Fax: 860-443-3171
Mailing address:
  • Phone: 860-443-3171
  • Fax: 860-443-3171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0010922
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: