Provider Demographics
NPI:1477065241
Name:PEPE, JEFFREY ROBERT (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ROBERT
Last Name:PEPE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-2675
Mailing Address - Country:US
Mailing Address - Phone:860-236-1988
Mailing Address - Fax:860-236-9507
Practice Address - Street 1:324 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-2675
Practice Address - Country:US
Practice Address - Phone:860-236-1988
Practice Address - Fax:860-236-9507
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.15069183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist