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Individual

KRISAN BRADLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
25 BOSTON POST RD, ORANGE, CT 06477-3203
(203) 859-3695
(203) 937-2536
Mailing address
25 BOSTON POST RD, ORANGE, CT 06477-3203
(203) 859-3695
(203) 937-2536

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
PTN.0012061
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTN.0012061
PHARMACY TECHNICIAN
CT
Enumeration date
02/06/2015
Last updated
02/06/2015
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