Individual
ILLENE CHELSEA DEZFULI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
204 BUOY LN, EAST LYME, CT 06333-1777
(203) 688-9450
Mailing address
204 BUOY LN, EAST LYME, CT 06333-1777
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0016422
CT
1835P2201X
Ambulatory Care Pharmacist
Primary
0016422
CT
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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