Provider Demographics
NPI:1003278185
Name:DOMBROWSKI, DEBBIE A
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:A
Last Name:DOMBROWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HOLLOW TREE LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-2646
Mailing Address - Country:US
Mailing Address - Phone:203-673-4286
Mailing Address - Fax:
Practice Address - Street 1:7 DURANT AVE
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-1906
Practice Address - Country:US
Practice Address - Phone:203-794-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist