Provider Demographics
NPI:1518021138
Name:COLEMAN, CRAIG IAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:IAN
Last Name:COLEMAN
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 1:20 COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-3412
Mailing Address - Country:US
Mailing Address - Phone:860-545-2096
Mailing Address - Fax:860-545-2277
Practice Address - Street 1:80 SEYMOUR ST # CB309
Practice Address - Street 2:HARTFORD HOSPITAL
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-8000
Practice Address - Country:US
Practice Address - Phone:860-545-2096
Practice Address - Fax:860-545-2277
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT95761835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy