Provider Demographics
NPI:1891209458
Name:TANSKI, JAMES T (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:T
Last Name:TANSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-4701
Mailing Address - Country:US
Mailing Address - Phone:860-585-1103
Mailing Address - Fax:
Practice Address - Street 1:1400 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4701
Practice Address - Country:US
Practice Address - Phone:860-585-1103
Practice Address - Fax:860-585-1118
Is Sole Proprietor?:No
Enumeration Date:2017-11-18
Last Update Date:2017-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist