Provider Demographics
NPI:1679179329
Name:CERVEIRA, ANDREA ISABEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:ISABEL
Last Name:CERVEIRA
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 1:92 LOOMIS RD
Mailing Address - Street 2:
Mailing Address - City:BOLTON
Mailing Address - State:CT
Mailing Address - Zip Code:06043-7828
Mailing Address - Country:US
Mailing Address - Phone:860-805-7372
Mailing Address - Fax:
Practice Address - Street 1:7 EAST HAMPTON ROAD
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:CT
Practice Address - Zip Code:06447
Practice Address - Country:US
Practice Address - Phone:860-467-9138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0014542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist