Healthcare Provider Details

I. General information

NPI: 1316866007
Provider Name (Legal Business Name): STEPHEN JOHN DIMARIA RPH, BS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

682 MAIN ST
MIDDLETOWN CT
06457-2733
US

IV. Provider business mailing address

PO BOX 1635
TORRINGTON CT
06790-1635
US

V. Phone/Fax

Practice location:
  • Phone: 860-894-7683
  • Fax: 860-894-7685
Mailing address:
  • Phone: 860-751-9734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0009701
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: