Provider Demographics
NPI:1194491530
Name:PADREVITA, THOMAS FRANCIS (PHARMD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:FRANCIS
Last Name:PADREVITA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 PALOMBA DR
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-3801
Mailing Address - Country:US
Mailing Address - Phone:860-253-0463
Mailing Address - Fax:
Practice Address - Street 1:71 PALOMBA DR
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-3801
Practice Address - Country:US
Practice Address - Phone:860-749-4184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0015666183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist