Individual
MR. RONALD JOEL WISSUCHEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACISTS
Contact information
Practice address
1291 ALBANY AVE, HARTFORD, CT 06112-2198
(860) 560-1881
(860) 560-0614
Mailing address
1291 ALBANY AVE, HARTFORD, CT 06112-2198
(860) 560-1881
(860) 560-0614
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
0006212
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006212
CONNECTICUT STATE PHARMACIST LIC
CT
Enumeration date
03/15/2011
Last updated
03/15/2011
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