Healthcare Provider Details

I. General information

NPI: 1306083191
Provider Name (Legal Business Name): JOHN SZYMANSKI PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2009
Last Update Date: 01/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N MAIN ST
WHITE RIVER JUNCTION VT
05009-0001
US

IV. Provider business mailing address

215 N MAIN ST
WHITE RIVER JUNCTION VT
05009-0001
US

V. Phone/Fax

Practice location:
  • Phone: 802-295-9363
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberPCT.0011099
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: