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General NPI Number Information
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NPI Number | 1457976375
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Entity Type | Individual
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Provider Name | TERESA ROSE GARLICK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2020
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Last Update Date | 06/16/2020
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Provider Practice Location Address
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Address Line | 941 BRIDGEPORT AVE STE M5
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City | MILFORD
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State | CT
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Zip | 06460-3142
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Country | US
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Telephone | 203-301-8861
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Fax | 203-405-8202
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Provider Business Mailing Address
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Address Line | 941 BRIDGEPORT AVE STE M5
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City | MILFORD
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State | CT
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Zip | 06460-3142
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Country | US
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Telephone | 860-986-4843
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Fax |
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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 | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number | PCT.0014577
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License Number State | CT
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