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Individual

JUSTIN MA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1407 FAIRFIELD AVE, BRIDGEPORT, CT 06605-1928
(203) 367-4571
Mailing address
1196 OLD COUNTRY RD, RIVERHEAD, NY 11901-2066
(631) 208-0239

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
063971
NY
183500000X
Pharmacist
15467
CT

Other

Enumeration date
07/06/2020
Last updated
01/15/2026
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