Kenneth J Fisher, RPH
Individual provider Active NPI Pharmacist · Unionville, CT
NPI 1497730105 · NPPES record last updated Mar 8, 2011
Key facts
- NPI
- 1497730105
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PCT.0008096 (CT)
- Practice address
- 12 Cedar LN
Unionville, CT 06085-1154 - Phone
- (860) 550-5831
- NPI assigned
- Dec 14, 2005
- 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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0008096 | CT | MD | Nuclear Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PCT.0008096 | CT | Yes |
| Nuclear Pharmacist | 1835N0905X | PCT.0008096 | CT |
Addresses
Primary practice location
12 Cedar LN
Unionville, CT 06085-1154
Mailing address
12 Cedar LN
Unionville, CT 06085-1154
Phone (860) 550-5831
Other providers in Unionville, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2011. 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.