NPI 1003270125

Dereck Realejo

Practitioner Pharmacist New London, CT

Practice location

Address: 817 Bank St, New London, CT 06320
Phone: (860) 443-5359
Fax: (860) 440-3336

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 13436 (CT)

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Registry record

NPI: 1003270125
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Apr 2016
Record last updated: 6 Apr 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.