Individual
LOREAL FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
644 W PUTNAM AVE, GREENWICH, CT 06830-6088
(203) 422-2022
Mailing address
13329 BOSS ST, OZONE PARK, NY 11417-2618
(347) 202-3130
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0015468
CT
183500000X
Pharmacist
071175
NY
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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