Provider Demographics
NPI:1295877017
Name:WHITNEY, LAUREEN (RPH)
Entity type:Individual
Prefix:
First Name:LAUREEN
Middle Name:
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WINTERBROOK RD
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:CT
Mailing Address - Zip Code:06716-1341
Mailing Address - Country:US
Mailing Address - Phone:203-879-3087
Mailing Address - Fax:
Practice Address - Street 1:BREWSTER ROAD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06011
Practice Address - Country:US
Practice Address - Phone:860-585-3232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist