Individual
JESSICA INES PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
633 WASHINGTON ST, MIDDLETOWN, CT 06457-2542
(860) 346-7628
(860) 346-0090
Mailing address
77 SUMMIT ST, NEWINGTON, CT 06111
(860) 707-9672
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
00113322
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011322
RPH LIC/ REG NO
CT
Enumeration date
10/19/2011
Last updated
10/19/2011
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