Provider Demographics
NPI:1053806471
Name:ZEITLER, SUSAN LOUISE (RPH)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:LOUISE
Last Name:ZEITLER
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 1:72 NEWTOWN RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6254
Mailing Address - Country:US
Mailing Address - Phone:203-798-0735
Mailing Address - Fax:
Practice Address - Street 1:72 NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6254
Practice Address - Country:US
Practice Address - Phone:203-798-0735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7417183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist