Provider Demographics
NPI:1881380384
Name:SKINZERA, AMBER (PHARMD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:SKINZERA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 ROCKWELL AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-5944
Mailing Address - Country:US
Mailing Address - Phone:860-845-7348
Mailing Address - Fax:
Practice Address - Street 1:212 ROCKWELL AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-5944
Practice Address - Country:US
Practice Address - Phone:860-845-7348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0015867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist