Provider Demographics
NPI:1992045843
Name:MORGAN, RONDA OTT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RONDA
Middle Name:OTT
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 HUMISTON DR
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:CT
Mailing Address - Zip Code:06524-3175
Mailing Address - Country:US
Mailing Address - Phone:203-815-3181
Mailing Address - Fax:
Practice Address - Street 1:1100 NEW HAVEN RD
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-5016
Practice Address - Country:US
Practice Address - Phone:203-729-2288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10732183500000X
FLPS48945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist