Individual
ANNEMARIE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1875 BOSTON AVE, BRIDGEPORT, CT 06610-2623
(203) 330-8278
Mailing address
359 WHEELER RD, MONROE, CT 06468-1918
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0014485
CT
Other
Enumeration date
03/30/2020
Last updated
03/30/2020
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