Individual
DEMETRIA MARY MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
220 ALBANY TPKE, CANTON, CT 06019-2565
(860) 693-8329
Mailing address
44 REPUBLIC DR APT 339, BLOOMFIELD, CT 06002-5460
(603) 969-5564
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0014531
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PCT.0014531
PHARMACIST LICENSE
CT
Enumeration date
09/04/2019
Last updated
09/04/2019
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