Individual
SCOTT R DECESARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1075 KENNEDY RD, TARGET PHARMACY STORE NUMBER (T-2213), WINDSOR, CT 06095-1308
(860) 907-3069
Mailing address
1075 KENNEDY RD, TARGET PHARMACY STORE NUMBER (T-2213), WINDSOR, CT 06095-1308
(860) 907-3069
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0008812
CT
183500000X
Pharmacist
PH24120
MA
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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