Provider Demographics
NPI:1548543747
Name:PAL, BRENDAN BUNTHY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:BUNTHY
Last Name:PAL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 BRANCH ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-1833
Mailing Address - Country:US
Mailing Address - Phone:978-430-1187
Mailing Address - Fax:
Practice Address - Street 1:54 PLAIN ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-4419
Practice Address - Country:US
Practice Address - Phone:978-453-7538
Practice Address - Fax:978-934-8874
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH26532183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist