Provider Demographics
NPI:1063012169
Name:PAXI, ANNA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:PAXI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SAXTON LN
Mailing Address - Street 2:
Mailing Address - City:BROAD BROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06016-1600
Mailing Address - Country:US
Mailing Address - Phone:860-758-7674
Mailing Address - Fax:
Practice Address - Street 1:3465 BERLIN TPKE
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-5106
Practice Address - Country:US
Practice Address - Phone:860-665-7813
Practice Address - Fax:860-665-0819
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0009214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist