Provider Demographics
NPI:1821691320
Name:MARGISON, KYLE MICHAEL (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:MICHAEL
Last Name:MARGISON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 NEW BRITAIN AVE APT S3
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062-2040
Mailing Address - Country:US
Mailing Address - Phone:203-577-7893
Mailing Address - Fax:
Practice Address - Street 1:690 WETHERSFIELD AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06114-1930
Practice Address - Country:US
Practice Address - Phone:860-296-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0014821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist