Provider Demographics
NPI:1821508656
Name:BEBYN, AUSTIN ARTHUR
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:ARTHUR
Last Name:BEBYN
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 1:1298 HARTFORD TPKE APT 1E
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-2176
Mailing Address - Country:US
Mailing Address - Phone:203-809-2204
Mailing Address - Fax:855-768-0828
Practice Address - Street 1:81 STONY HILL ROAD
Practice Address - Street 2:BIG Y PHARMACY
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:203-791-9820
Practice Address - Fax:855-768-0828
Is Sole Proprietor?:No
Enumeration Date:2017-10-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH26287183500000X
CT6681183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist