Individual
DERECK REALEJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
817 BANK ST, NEW LONDON, CT 06320
(860) 443-5359
(860) 440-3336
Mailing address
817 BANK ST, NEW LONDON, CT 06320
(860) 443-5359
(860) 440-3336
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13436
CT
Other
Enumeration date
04/06/2016
Last updated
04/06/2016
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