Provider Demographics
NPI:1508215815
Name:RINDFLEISCH, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:RINDFLEISCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-7852
Mailing Address - Country:US
Mailing Address - Phone:860-416-9165
Mailing Address - Fax:
Practice Address - Street 1:1279 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3101
Practice Address - Country:US
Practice Address - Phone:203-755-5490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT08531183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist