Individual
STEPHEN NICHOLAS DISANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1030 WOLCOTT ST, WATERBURY, CT 06705-1316
(203) 754-3636
Mailing address
1030 WOLCOTT ST, WATERBURY, CT 06705-1316
(203) 754-3636
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0011734
CT
Other
Enumeration date
07/22/2011
Last updated
07/24/2011
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