Provider Demographics
NPI:1295332856
Name:WESTPHAL, NOAH (PHARMD)
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:
Last Name:WESTPHAL
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 1:60 HAWLEY AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-8116
Mailing Address - Country:US
Mailing Address - Phone:507-340-6204
Mailing Address - Fax:
Practice Address - Street 1:215 FEDERAL RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2630
Practice Address - Country:US
Practice Address - Phone:203-740-1005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0015332183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist