Individual
MRS. JENNIFER M DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
82 HOYT ST, STAMFORD, CT 06905-5701
(203) 325-1260
Mailing address
90 WICKS LN, MALVERNE, NY 11565-2253
(516) 807-0583
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0009384
CT
Other
Enumeration date
09/07/2011
Last updated
09/07/2011
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