Provider Demographics
NPI:1083907950
Name:DELDEBBIO, JOHN E JR (BS, RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:E
Last Name:DELDEBBIO
Suffix:JR
Gender:M
Credentials:BS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 KATHRYN LN
Mailing Address - Street 2:
Mailing Address - City:PLANTSVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06479-1382
Mailing Address - Country:US
Mailing Address - Phone:860-378-0351
Mailing Address - Fax:
Practice Address - Street 1:277 FAIRFIELD AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-4068
Practice Address - Country:US
Practice Address - Phone:203-596-8192
Practice Address - Fax:203-597-0707
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist