Provider Demographics
NPI:1720598220
Name:BOBIK, EDYTA (PHARM D)
Entity Type:Individual
Prefix:
First Name:EDYTA
Middle Name:
Last Name:BOBIK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2701
Mailing Address - Country:US
Mailing Address - Phone:203-453-7446
Mailing Address - Fax:203-453-7479
Practice Address - Street 1:830 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2701
Practice Address - Country:US
Practice Address - Phone:203-453-7446
Practice Address - Fax:203-453-7479
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0010367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist