Rosa Lavoura

Individual provider Active NPI Pharmacist · Old Greenwich, CT

NPI 1457720005 · NPPES record last updated Sep 24, 2015

Key facts

NPI
1457720005
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
0007872 (CT)
Practice address
20 Maple Dr
Old Greenwich, CT 06870-1411
Phone
(203) 273-4054
NPI assigned
Sep 24, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0007872CTMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0007872 CT Yes

Addresses

Primary practice location

20 Maple Dr
Old Greenwich, CT 06870-1411

Mailing address

20 Maple Dr
Old Greenwich, CT 06870-1411

Other providers in Old Greenwich, CT

All providers in Old Greenwich, CT · Pharmacist in Connecticut

Sources for this page

Verify at the official NPI Registry.