Judith A Brennan, PHARMD
Individual provider Active NPI Pharmacist · Brattleboro, VT
NPI 1770097099 · NPPES record last updated Nov 22, 2017
Key facts
- NPI
- 1770097099
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 033.0130803 (VT)
- Practice address
- 499 Canal St
Brattleboro, VT 05301-7112 - Phone
- (802) 257-4204
- NPI assigned
- Nov 22, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 033.0130803 | VT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maxi Green Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 033.0130803 | VT | Yes |
Addresses
Primary practice location
499 Canal St
Brattleboro, VT 05301-7112
Mailing address
499 Canal St
Brattleboro, VT 05301-7112
Other providers in Brattleboro, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2017. 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.