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General NPI Number Information
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NPI Number | 1912642323
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Entity Type | Organization
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Legal Business Name | THURBER THERAPEUTICS LLC
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Dates
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Enumeration Date | 04/29/2022
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Last Update Date | 04/29/2022
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Provider Practice Location Address
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Address Line | 340 BROAD ST STE 100
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City | WINDSOR
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State | CT
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Zip | 06095-3030
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Country | US
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Telephone | 860-368-1775
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Fax |
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Provider Business Mailing Address
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Address Line | 127 CARRIAGE DR
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City | GLASTONBURY
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State | CT
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Zip | 06033-3229
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Country | US
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Telephone | 860-368-1775
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHENIE THURBER
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Credential | DO
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Telephone | 860-368-1775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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