Provider Demographics
NPI:1134402548
Name:JENSEN, CURTIS W (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:W
Last Name:JENSEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SHAKER RD
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-3112
Mailing Address - Country:US
Mailing Address - Phone:860-253-0463
Mailing Address - Fax:
Practice Address - Street 1:2 SHAKER RD
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-3112
Practice Address - Country:US
Practice Address - Phone:860-253-0463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0010376183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist