Provider Demographics
NPI:1023142999
Name:PATTEN, PETER J (RPH)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:J
Last Name:PATTEN
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 1:13 MEADOW POINT RD
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06498
Mailing Address - Country:US
Mailing Address - Phone:860-669-7128
Mailing Address - Fax:
Practice Address - Street 1:13 MEADOW POINT RD
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:CT
Practice Address - Zip Code:06498-1616
Practice Address - Country:US
Practice Address - Phone:860-669-7128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4091183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist