Provider Demographics
NPI:1912642323
Name:THURBER THERAPEUTICS LLC
Entity Type:Organization
Organization Name:THURBER THERAPEUTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHENIE
Authorized Official - Middle Name:
Authorized Official - Last Name:THURBER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:860-368-1775
Mailing Address - Street 1:127 CARRIAGE DR
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-3229
Mailing Address - Country:US
Mailing Address - Phone:860-368-1775
Mailing Address - Fax:
Practice Address - Street 1:340 BROAD ST STE 100
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-3030
Practice Address - Country:US
Practice Address - Phone:860-368-1775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty