Healthcare Provider Details

I. General information

NPI: 1669389912
Provider Name (Legal Business Name): BRITANY MICHELLE BERMUDEZ PABON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 BROAD ST
PROVIDENCE RI
02905-1822
US

IV. Provider business mailing address

57 CAMERON ST APT 2
PAWTUCKET RI
02861-1770
US

V. Phone/Fax

Practice location:
  • Phone: 401-461-4383
  • Fax:
Mailing address:
  • Phone: 939-232-5960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH06908
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: