Individual
STACEY LAUREN OLIVETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
930 N COLONY RD, WALLINGFORD, CT 06492-2471
(203) 265-3942
(844) 411-6449
Mailing address
930 N COLONY RD, WALLINGFORD, CT 06492-2471
(203) 265-3942
(844) 411-6449
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
11092
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11092
STATE PHARMACIST LICENSE
CT
Enumeration date
11/14/2016
Last updated
11/14/2016
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