Provider Demographics
NPI:1427342195
Name:BRIGHTMAN, DAVID MARC (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MARC
Last Name:BRIGHTMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1350 STANLEY ST
Mailing Address - Street 2:RITEAID PHARMACY 10343
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-3224
Mailing Address - Country:US
Mailing Address - Phone:860-224-7798
Mailing Address - Fax:860-224-7942
Practice Address - Street 1:1350 STANLEY ST
Practice Address - Street 2:RITEAID PHARMACY 10343
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-3224
Practice Address - Country:US
Practice Address - Phone:860-224-7798
Practice Address - Fax:860-224-7942
Is Sole Proprietor?:No
Enumeration Date:2011-05-30
Last Update Date:2011-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8989183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist