Individual
GARY JULES BANGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
155 WATERFORD PARKWAY N, WATERFORD, CT 06385-1208
(860) 447-3747
Mailing address
155 PARKWAY NORTH, WATERFORD, CT 06385
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0007343
CT
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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