Individual
DIANE HERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
203 RIVERSIDE AVE, RIVERSIDE, CT 06878-2212
(203) 247-6493
Mailing address
203 RIVERSIDE AVE, RIVERSIDE, CT 06878-2212
(203) 247-6493
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0007764
CT
Other
Enumeration date
01/07/2021
Last updated
01/07/2021
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