Provider Demographics
NPI:1407565740
Name:BRAMBLE, DANA (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:BRAMBLE
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 1:40 PRATT ST
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06118-1526
Mailing Address - Country:US
Mailing Address - Phone:860-478-8045
Mailing Address - Fax:
Practice Address - Street 1:120 SALMON BROOK ST
Practice Address - Street 2:
Practice Address - City:GRANBY
Practice Address - State:CT
Practice Address - Zip Code:06035-2652
Practice Address - Country:US
Practice Address - Phone:860-844-8331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0016060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist