Provider Demographics
NPI:1972631000
Name:HATCH, BRUCE DAVID (RPH)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:DAVID
Last Name:HATCH
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 1:1 WICKEN SQ
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3835
Mailing Address - Country:US
Mailing Address - Phone:518-452-9224
Mailing Address - Fax:518-237-5533
Practice Address - Street 1:1 WICKEN SQ
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3835
Practice Address - Country:US
Practice Address - Phone:518-452-9224
Practice Address - Fax:518-237-5533
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032516183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist