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General NPI Number Information
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NPI Number | 1073803078
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Entity Type | Individual
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Provider Name | NATHANIEL GILMAN PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 75 BOSTON POST RD
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City | WATERFORD
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State | CT
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Zip | 06385-2423
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Country | US
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Telephone | 860-437-8880
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Fax | 860-440-3417
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Provider Business Mailing Address
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Address Line | 94 ELDERKIN AVE
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City | GROTON
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State | CT
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Zip | 06340-4912
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Country | US
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Telephone | 401-290-7082
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Fax | 860-440-3417
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PCT.0011080
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License Number State | CT
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