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Individual

MR. GLENN JAY MASON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
16 STONYBROOK RD, NORWALK, CT 06851-2311
(203) 846-4601
Mailing address
16 STONYBROOK RD, NORWALK, CT 06851-2311
(203) 846-4601

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6298
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6298
CT PHARMACY LICENSE NUMBER
CT
Enumeration date
03/10/2010
Last updated
03/10/2010
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