Individual
DAVID JOHN BROCCOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
335 PRAIRIE AVE, PROVIDENCE, RI 02905
(401) 781-4325
Mailing address
335 PRAIRIE AVE, PROVIDENCE, RI 02905
(401) 781-4325
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH05331
RI
Other
Enumeration date
12/10/2010
Last updated
07/09/2014
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