Individual
DR. KENNETH BREAUX SEGRETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
141 HANNAFORD SQ # 2, BENNINGTON, VT 05201-1653
(802) 442-3642
(802) 442-3065
Mailing address
141 HANNAFORD SQ # 2, BENNINGTON, VT 05201-1653
(802) 442-3642
(802) 442-3065
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
033-0003660
VT
183500000X
Pharmacist
54252
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183500000X
—
NY
05
—
183500000X
—
VT
Enumeration date
04/02/2010
Last updated
09/23/2010
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