Healthcare Provider Details

I. General information

NPI: 1609467273
Provider Name (Legal Business Name): ROBERT S ZIRLIS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2021
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 FAIRFIELD BLVD UNIT C2
WALLINGFORD CT
06492-5903
US

IV. Provider business mailing address

7 STONEWALL LN
CLINTON CT
06413-2531
US

V. Phone/Fax

Practice location:
  • Phone: 203-691-9619
  • Fax: 203-815-1661
Mailing address:
  • Phone: 860-969-4404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT0008225
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: