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General NPI Number Information
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NPI Number | 1790838365
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Entity Type | Organization
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Legal Business Name | NORTH STREET PHARMACY
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 06/11/2010
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Provider Practice Location Address
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Address Line | 1043 NORTH STREET
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City | GREENWICH
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State | CT
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Zip | 06831-2701
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Country | US
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Telephone | 203-869-2130
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Fax | 203-869-9227
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Provider Business Mailing Address
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Address Line | 1043 NORTH STREET
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City | GREENWICH
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State | CT
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Zip | 06831-2701
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Country | US
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Telephone | 203-869-2130
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Fax | 203-869-9227
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Authorized Official
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Title or Position | PHARMACY MANAGER OWNER
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Name | MR. PAUL ANDREW FISCELLA
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Credential | RPH
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Telephone | 12038692130
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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 | 0741
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License Number State | CT
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