Provider Demographics
NPI:1134330632
Name:GIRGASKY, JANE E (RPH)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:E
Last Name:GIRGASKY
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 1:682 MAIN ST S
Mailing Address - Street 2:P.O. BOX 388
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798-3736
Mailing Address - Country:US
Mailing Address - Phone:203-263-2282
Mailing Address - Fax:203-263-4030
Practice Address - Street 1:682 MAIN ST S
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-3736
Practice Address - Country:US
Practice Address - Phone:203-263-2282
Practice Address - Fax:203-263-4030
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT8968183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist