Theriault, Mark David

Theriault, Mark David is an individual health care provider with primary practice located at 17 Hillhouse Ave , New Haven CT 06520. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Theriault, Mark David can be contacted via phone (203) 432-2885.

Contact Information

Primary practice address
17 Hillhouse Ave New Haven CT 06520
Phone: (203) 432-2885
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 9583 Connecticut

Profile Details

NPI number 1144359894
LBN Legal business name Theriault, Mark David
Credentials PHARMD
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 5th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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