Provider Demographics
NPI:1003360371
Name:SERAFINO, RONALD GEORGE (PHARMD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:GEORGE
Last Name:SERAFINO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2517
Mailing Address - Country:US
Mailing Address - Phone:860-628-7979
Mailing Address - Fax:860-628-9008
Practice Address - Street 1:36 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-2517
Practice Address - Country:US
Practice Address - Phone:860-628-7979
Practice Address - Fax:860-628-9008
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist