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Individual

MR. MARK PETER PETRUZZI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
78 ELIZABETH ST, SOUTH WINDSOR, CT 06074-3411
(860) 528-5019
Mailing address
56 SHIPMAN DR, GLASTONBURG, CT 06033
(860) 633-1343

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
4633
CT
183500000X
Pharmacist
Primary
PCT4633
CT
183500000X
Pharmacist
PH24321
MA

Other

Enumeration date
05/26/2005
Last updated
11/04/2011
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