Individual
ANTHONY SCIULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
286 BROAD ST, MANCHESTER, CT 06040-4049
(860) 647-0325
(860) 647-0325
Mailing address
286 BROAD ST, MANCHESTER, CT 06040-4049
(860) 647-0325
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5602
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004122438
—
CT
Enumeration date
05/28/2017
Last updated
05/28/2017
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