Jeffrey Paul Dalessandro, RPH

Individual provider Active NPI Pharmacist · Prospect, CT

NPI 1831230739 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1831230739
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
7101 (CT)
Practice address
Ezpharm Pharmacy
166 Waterbury Rd
Prospect, CT 06712
Phone
(203) 758-7227
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
7101CTMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7101 CT Yes

Addresses

Primary practice location

Ezpharm Pharmacy
166 Waterbury Rd
Prospect, CT 06712

Mailing address

59 Desorbo Dr
Southington, CT 06489-2201
Phone (860) 621-3169

Other providers in Prospect, CT

All providers in Prospect, CT · Pharmacist in Connecticut

Sources for this page

Verify at the official NPI Registry.