Provider Demographics
NPI:1225010101
Name:PARISI, PETER (R PH)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:PARISI
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 NORTHFORD RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-5546
Mailing Address - Country:US
Mailing Address - Phone:203-269-8558
Mailing Address - Fax:
Practice Address - Street 1:35 ONTARIO ST
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-7135
Practice Address - Country:US
Practice Address - Phone:203-375-8000
Practice Address - Fax:203-345-0171
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist