Individual
DAVID ALLAN VANGEERSDAELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
763 STRAITS TPKE STOP & SHOP #657, WATERTOWN, CT 06795-3318
(860) 274-7461
(860) 274-6124
Mailing address
763 STRAITS TPKE STOP, WATERTOWN, CT 06795-3318
(860) 274-7461
(860) 274-6124
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0005564
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
409257
NABP
CT
Enumeration date
05/12/2017
Last updated
05/12/2017
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