Provider Demographics
NPI:1790849115
Name:HRITCKO, PHILIP MICHAEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:MICHAEL
Last Name:HRITCKO
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 1:89 HAREN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1063
Mailing Address - Country:US
Mailing Address - Phone:860-563-2185
Mailing Address - Fax:
Practice Address - Street 1:111 SALEM TPKE
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-6459
Practice Address - Country:US
Practice Address - Phone:860-892-2711
Practice Address - Fax:
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
CT67561835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy