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NPI Code Detail

MEDICARE: WALTER MARTUCCI RPH

MEDICARE: WALTER MARTUCCI RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist6110CT

General Provider Information

NPI Number : 1588010979
Entity Type Code : Individual
Provider Name (Legal Business Name) : WALTER MARTUCCI RPH
Provider Business Mailing Address
First Line : 67 PROSPECT HILL RD
Second Line :
City : EAST WINDSOR
State : CT
Zip : 06088-3605
Country : US
Telephone Number : 860-623-1407
Fax Number :
Provider Business Practice Location Address
First Line : 67 PROSPECT HILL RD
Second Line :
City : EAST WINDSOR
State : CT
Zip : 06088-3605
Country : US
Telephone Number : 860-623-1407
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2016
Last Update Date : 05/04/2016

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Directions to “ WALTER MARTUCCI RPH” Practice Location

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