Provider Demographics
NPI:1245717156
Name:NEWPORT, RONALD A (RPH)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:A
Last Name:NEWPORT
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 1:129 PEILA DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-6459
Mailing Address - Country:US
Mailing Address - Phone:860-643-4909
Mailing Address - Fax:
Practice Address - Street 1:940 SILVER LN
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06118-1235
Practice Address - Country:US
Practice Address - Phone:860-569-7135
Practice Address - Fax:860-895-8368
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.005873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty