Provider Demographics
NPI:1174272389
Name:DAUTI, DREDHZA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DREDHZA
Middle Name:
Last Name:DAUTI
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 1:82 HEATHER LN
Mailing Address - Street 2:
Mailing Address - City:TERRYVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06786-7111
Mailing Address - Country:US
Mailing Address - Phone:203-768-0251
Mailing Address - Fax:
Practice Address - Street 1:81 NORTH ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4152
Practice Address - Country:US
Practice Address - Phone:860-584-8998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0015674183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist