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General NPI Number Information
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NPI Number | 1396096749
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Entity Type | Individual
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Provider Name | DIANA SHNITMAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/25/2012
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Last Update Date | 09/25/2012
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Provider Practice Location Address
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Address Line | 674 FARMINGTON AVE
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City | WEST HARTFORD
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State | CT
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Zip | 06119-1810
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Country | US
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Telephone | 860-523-5849
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Fax |
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Provider Business Mailing Address
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Address Line | 51 CARLYLE RD
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City | WEST HARTFORD
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State | CT
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Zip | 06117-1326
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Country | US
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Telephone | 860-478-2285
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Fax |
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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.0012406
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License Number State | CT
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