Individual
MR. MICHAEL A MASTROIANNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
STOLLS PHARMACY INC, 185 GROVE ST, WATERBURY, CT 06710
(203) 575-0199
(203) 575-0515
Mailing address
STOLLS PHARMACY INC, 185 GROVE ST, WATERBURY, CT 06710
(203) 575-0199
(203) 575-0515
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0007580
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004083234
—
CT
01
—
0139070001
MEDICARE
CT
Enumeration date
04/23/2019
Last updated
04/23/2019
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