Dereck Realejo Valid NPI
Individual provider · Pharmacist · New London, CT
- NPI
- 1003270125
- Type
- Individual (Type 1)
- Primary specialty
- Pharmacist
- Specialty group
- Pharmacy Service Providers
- Taxonomy code
- 183500000X
- License number
- 13436 (CT)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2016-04-06
- Last updated
- 2016-04-06
Practice location
817 Bank St
New London, CT 06320
(860) 443-5359