William N Bruneau III, PHARMD
Individual provider Active NPI Pharmacist · New Haven, CT
NPI 1063076487 · NPPES record last updated May 1, 2019
Key facts
- NPI
- 1063076487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PCT.0014158 (CT)
- Practice address
- 20 York St
New Haven, CT 06510-3202 - Phone
- (203) 688-1111
- NPI assigned
- May 1, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0014158 | CT | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PCT.0014158 | CT | Yes |
Addresses
Primary practice location
20 York St
New Haven, CT 06510-3202
Mailing address
6-3 W Meadow LN
Middletown, CT 06457-1656
Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.