Provider Demographics
NPI:1043503188
Name:LIROT, PATRICIA (RPH, BS)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:LIROT
Suffix:
Gender:F
Credentials:RPH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 374
Mailing Address - Street 2:90 HALLS ROAD
Mailing Address - City:OLD LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06371-0374
Mailing Address - Country:US
Mailing Address - Phone:860-434-8111
Mailing Address - Fax:860-434-5465
Practice Address - Street 1:90 HALLS RD
Practice Address - Street 2:
Practice Address - City:OLD LYME
Practice Address - State:CT
Practice Address - Zip Code:06371-4406
Practice Address - Country:US
Practice Address - Phone:860-434-8111
Practice Address - Fax:860-434-5465
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist