DR. MARK DAVID THERIAULT (NPI# 1144359894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144359894 |
| Entity Type | Individual |
| Full Name | DR. MARK DAVID THERIAULT |
| Credential | PHARMD |
| Practice Address |
17 Hillhouse Ave New Haven CT 06520 |
| Mailing Address |
65 Walt Dr Meriden CT 06450-6823 |
| Practice Telephone | 2034322885 |
| Mailing Telephone | 2036307037 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 9583 | CT | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437159746 | Mark Theriault | Chiropractor | 1895 N Highway 16, Denver, NC 28037-8642 | 2005-07-28 |
| Street Address |
17 HILLHOUSE AVE |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427027689 | Kelley Anderson Esposito | Physical Therapist | 17 Hillhouse Ave, New Haven, CT 06511-8965 | 2006-03-17 |
| 1386885523 | Michael Goulet | Specialist | 17 Hillhouse Ave, New Haven, CT 06511-8965 | 2009-03-18 |
| 1356582514 | Brenda Matzkin | Specialist | 17 Hillhouse Ave, New Haven, CT 06511-8965 | 2009-03-18 |
| 1164663324 | Nancy Banack | Specialist | 17 Hillhouse Ave, Yale University Health Services, New Haven, CT 06511 | 2009-03-18 |
| 1871734020 | Lynda Boynton | Specialist | 17 Hillhouse Ave, New Haven, CT 06511-8965 | 2009-03-18 |
| 1609013986 | David Francis Brzozowski | Pharmacist | 17 Hillhouse Ave, New Haven, CT 06511-8965 | 2009-01-08 |
| 1659570182 | Margaret Becker | Nurse Practitioner | 17 Hillhouse Ave, New Haven, CT 06511-6815 | 2007-07-14 |
| 1972710614 | John W Blanton | Pediatrics | 17 Hillhouse Ave, New Haven, CT 06511-6815 | 2007-05-16 |
| 1902010580 | Stephanie S. Spangler | Obstetrics & Gynecology | 17 Hillhouse Ave, New Haven, CT 06511-6815 | 2007-05-10 |
| 1003947375 | Martha Lee Asarisi | Pharmacist | 17 Hillhouse Ave, New Haven, CT 06511-6815 | 2007-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881124626 | Kathryn Elliott Nagel | Student in an Organized Health Care Education/Training Program | 15 York Street, Lmp 1091b, Ynhh - Im Pediatrics, New Haven, CT 06520 | 2017-06-14 |
| 1013399666 | Cosman Camilo Mandujano | Student in an Organized Health Care Education/Training Program | 330 Cedar Street Ynhh, Department of Surgery, New Haven, CT 06520 | 2015-06-19 |
| 1457619751 | Andrew Philip Notarianni | Anesthesiology | 333 Cedar St., Tompkins 3, Yusm Department of Anesthesiology, New Haven, CT 06520 | 2012-04-25 |
| 1619254992 | Deniz Balci | Student in an Organized Health Care Education/Training Program | Ankara Universitesi Ibni Sina Hastanesi, Genel Cerrahi Ad. Sihhiye, Ankara, ANKARA 06520 | 2011-11-15 |
| 1427333244 | Alexander Goehler | Radiology | 333 Cedar Steet, Yale New Haven Hospital, New Haven, CT 06520 | 2011-10-12 |
| 1841529575 | Maison Chen | Radiology | 333 Cedar St, Te2, Yale Dx Radiology, New Haven, CT 06520 | 2009-12-08 |
| 1134394323 | Nicole Marie Brown | Pediatrics | 333 Cedar Street Shm Ie-61, New Haven, CT 06520 | 2008-04-28 |
| 1851566228 | Arianne Jeaneve Boylan | Neurological Surgery | Yale Department of Neurosurgery, 333 Cedar Street, New Haven, CT 06520 | 2008-04-28 |
| 1679757629 | William Gee Chang | Internal Medicine | Bb114 330 Cedar St, Yale Nephrology, New Haven, CT 06520 | 2007-12-27 |
| 1447458666 | Alejandra Valencia | Psychologist | 230 South Frontage Rd., The Yale Child Study Center, New Haven, CT 06520 | 2007-07-10 |
| Find all providers in zip 06520 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336757319 | Matthew Peter O'connell | Pharmacist | 55 Park Street, Lower Level, Department of Pharmacy, New Haven, CT 06510 | 2020-07-16 |
| 1477171460 | Huy Henry Le | Pharmacist | 20 York Street, Ps-ll, New Haven, CT 06510 | 2020-07-07 |
| 1487212635 | Brittany Clarissa Langdon | Pharmacist | 1450 Chapel St Rm V140n, New Haven, CT 06511-4405 | 2019-06-03 |
| 1841704277 | Daniela Alzate-molina | Pharmacist | 249 Legion Ave, New Haven, CT 06519-5508 | 2017-11-21 |
| 1639694698 | Sunil Kumar Tickoo | Pharmacist | Berneys Pharmacy, 615 Howard Ave, New Haven, CT 06519-2112 | 2017-08-10 |
| 1265893143 | Leon Cushman | Pharmacist | 1168 Whalley Ave, New Haven, CT 06515-1705 | 2016-03-18 |
| 1871997627 | Bhumi Patel | Pharmacist | 44 Orange St, Apt 523, New Haven, CT 06510-3130 | 2014-10-22 |
| 1356612634 | David Eld | Pharmacist | 55 Park Street, Suite 1a, New Haven, CT 06511 | 2012-01-19 |
| 1780954719 | Rebecca Reeve | Pharmacist | 53 Park St, New Haven, CT 06511-5474 | 2012-01-06 |
| 1841568441 | Pamela Cavallo | Pharmacist | 55 Park St., New Haven, CT 06511 | 2011-12-09 |
| Find all providers in NEW HAVEN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.