Provider Demographics
NPI:1295459451
Name:YEAKLEY, PAUL C (RPH, PHARMD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:C
Last Name:YEAKLEY
Suffix:
Gender:M
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 MONTCLAIR DR
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06118-3327
Mailing Address - Country:US
Mailing Address - Phone:203-440-7546
Mailing Address - Fax:
Practice Address - Street 1:70 INWOOD RD STE 5
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3441
Practice Address - Country:US
Practice Address - Phone:860-727-4064
Practice Address - Fax:860-727-4084
Is Sole Proprietor?:No
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT15263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist