Provider Demographics
NPI:1215386958
Name:VARGHESE, DENNY (RPH)
Entity Type:Individual
Prefix:
First Name:DENNY
Middle Name:
Last Name:VARGHESE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-1877
Mailing Address - Country:US
Mailing Address - Phone:203-363-0627
Mailing Address - Fax:203-425-9924
Practice Address - Street 1:11 FOREST ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-1877
Practice Address - Country:US
Practice Address - Phone:203-363-0627
Practice Address - Fax:203-425-9924
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8866183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist