Provider Demographics
NPI:1467988022
Name:KUNNUMMEL, ASHLEY (RPH)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KUNNUMMEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 HILLDALE RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1434
Mailing Address - Country:US
Mailing Address - Phone:860-610-8055
Mailing Address - Fax:
Practice Address - Street 1:102 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-1826
Practice Address - Country:US
Practice Address - Phone:860-826-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0013708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist