Individual
ADELINE GIANUTSOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24 SHANDA LN, TOLLAND, CT 06084-3950
(860) 875-4478
Mailing address
24 SHANDA LN, L, TOLLAND, CT 06084-3950
(860) 875-4478
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5433
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2059
PHARMACY
RI
01
—
5433
PHARMACIST
CT
Enumeration date
08/08/2016
Last updated
08/08/2016
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