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General NPI Number Information
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NPI Number | 1194202762
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Entity Type | Individual
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Provider Name | THERESA MARIE MILKOVICH
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Gender | Female
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Dates
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Enumeration Date | 07/25/2018
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Last Update Date | 07/25/2018
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Provider Practice Location Address
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Address Line | 228 S MAIN ST
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City | NEWTOWN
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State | CT
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Zip | 06470-2764
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Country | US
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Telephone | 203-270-0827
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Fax | 203-426-3198
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Provider Business Mailing Address
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Address Line | 228 S MAIN ST
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City | NEWTOWN
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State | CT
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Zip | 06470-2764
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Country | US
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Telephone | 203-270-0827
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Fax | 203-426-3198
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PCT.0008542
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License Number State | CT
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