Healthcare Provider Details

I. General information

NPI: 1457296980
Provider Name (Legal Business Name): DEREK LINDIA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 PROVIDENCE RD
BROOKLYN CT
06234-3413
US

IV. Provider business mailing address

542 PROVIDENCE RD
BROOKLYN CT
06234-3413
US

V. Phone/Fax

Practice location:
  • Phone: 860-779-0523
  • Fax: 860-779-0322
Mailing address:
  • Phone: 860-779-0523
  • Fax: 860-779-0322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0015651
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: