Provider Demographics
NPI:1396034575
Name:HUBEL, BRYAN JAMES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:JAMES
Last Name:HUBEL
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 1:65 ALFRED STONE RD
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-6111
Mailing Address - Country:US
Mailing Address - Phone:401-864-7809
Mailing Address - Fax:
Practice Address - Street 1:456 BRANCH AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-2205
Practice Address - Country:US
Practice Address - Phone:401-331-3554
Practice Address - Fax:401-331-6092
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH04547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist