Individual
MARK YERUSHALMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
656 NEW HAVEN AVE, DERBY, CT 06418-2528
(203) 736-2667
Mailing address
656 NEW HAVEN AVE, DERBY, CT 06418-2528
(203) 736-2667
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
039043-1
NY
183500000X
Pharmacist
Primary
6827
CT
Other
Enumeration date
03/31/2010
Last updated
12/02/2014
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