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General NPI Number Information
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NPI Number | 1639539554
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Entity Type | Individual
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Provider Name | DANIEL GLEASON RPH
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Gender | Male
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 85 SEYMOUR ST SUITE 117
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City | HARTFORD
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State | CT
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Zip | 06106-5501
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Country | US
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Telephone | 860-727-1123
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Fax | 860-520-4307
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Provider Business Mailing Address
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Address Line | PO BOX 746
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City | EAST GRANBY
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State | CT
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Zip | 06026-0746
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Country | US
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Telephone |
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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 | PCT0008428
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS31997
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License Number State | FL
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