Provider Demographics
NPI:1114409562
Name:BARILE, DOREEN GAIL (RPH)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:GAIL
Last Name:BARILE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:846 NORTH COLONY ROAD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2410
Mailing Address - Country:US
Mailing Address - Phone:203-626-7765
Mailing Address - Fax:
Practice Address - Street 1:846 NORTH COLONY ROAD
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492
Practice Address - Country:US
Practice Address - Phone:203-626-7765
Practice Address - Fax:203-626-7767
Is Sole Proprietor?:No
Enumeration Date:2018-09-02
Last Update Date:2018-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT0005391183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist