Provider Demographics
NPI:1700179033
Name:MURAWSKI, RAYMOND STEVEN (RPH)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:STEVEN
Last Name:MURAWSKI
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 1:134 VANDERBILT RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-3661
Mailing Address - Country:US
Mailing Address - Phone:860-589-5734
Mailing Address - Fax:203-272-4868
Practice Address - Street 1:180 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2406
Practice Address - Country:US
Practice Address - Phone:203-272-3543
Practice Address - Fax:203-272-4868
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist