Provider Demographics
NPI:1578265245
Name:REID, ANDREA LEDUC (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LEDUC
Last Name:REID
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 1:87 W STAFFORD RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD SPRINGS
Mailing Address - State:CT
Mailing Address - Zip Code:06076-1044
Mailing Address - Country:US
Mailing Address - Phone:860-684-4597
Mailing Address - Fax:
Practice Address - Street 1:87 W STAFFORD RD
Practice Address - Street 2:
Practice Address - City:STAFFORD SPRINGS
Practice Address - State:CT
Practice Address - Zip Code:06076-1044
Practice Address - Country:US
Practice Address - Phone:860-684-5029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH23289183500000X
CT0009644183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist