Provider Demographics
NPI:1104197821
Name:RIZAL, ANUJA (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANUJA
Middle Name:
Last Name:RIZAL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SOUTH RD STE 230
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2483
Mailing Address - Country:US
Mailing Address - Phone:860-679-3470
Mailing Address - Fax:860-676-3446
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:MC6218
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-0001
Practice Address - Country:US
Practice Address - Phone:860-679-3470
Practice Address - Fax:860-679-1198
Is Sole Proprietor?:No
Enumeration Date:2012-01-26
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT87851835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy