Provider Demographics
NPI:1215399266
Name:NARDI, FREDERICK M (RPH)
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:M
Last Name:NARDI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 HOPMEADOW ST
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-2234
Mailing Address - Country:US
Mailing Address - Phone:860-651-1440
Mailing Address - Fax:860-651-3721
Practice Address - Street 1:714 HOPMEADOW ST
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-2234
Practice Address - Country:US
Practice Address - Phone:860-651-1440
Practice Address - Fax:860-651-3721
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist