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General NPI Number Information
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NPI Number | 1912554411
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Entity Type | Individual
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Provider Name | SYDNEY BRODEUR PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | 1149 UNIVERSITY DR
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City | BURLINGTON
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State | NC
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Zip | 27215-8798
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Country | US
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Telephone | 336-584-6041
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Fax |
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Provider Business Mailing Address
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Address Line | 622 WATERSTONE PARK CIR
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City | HILLSBOROUGH
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State | NC
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Zip | 27278-9884
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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 | 28889
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License Number State | NC
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