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General NPI Number Information
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NPI Number | 1669916805
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Entity Type | Individual
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Provider Name | ADESOLA REBECCA OSOSANWO PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/07/2016
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Last Update Date | 12/07/2016
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Provider Practice Location Address
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Address Line | 1093 N MAIN ST
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City | DAYVILLE
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State | CT
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Zip | 06241-2124
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Country | US
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Telephone | 860-774-0490
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Fax | 860-774-0483
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Provider Business Mailing Address
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Address Line | 149 WOODBINE ST APT 1L
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City | CRANSTON
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State | RI
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Zip | 02910-2952
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Country | US
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Telephone | 401-347-8881
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PCT.0013872
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License Number State | CT
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