Provider Demographics
NPI:1477878064
Name:ALLI, DOLAPO A (RPH)
Entity Type:Individual
Prefix:
First Name:DOLAPO
Middle Name:A
Last Name:ALLI
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 1:436 WHALLEY AVE
Mailing Address - Street 2:WALGREENS PHARMACY
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511
Mailing Address - Country:US
Mailing Address - Phone:203-777-8001
Mailing Address - Fax:203-777-0873
Practice Address - Street 1:WALGREENS PHARMACY, 436 WHALLEY AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511
Practice Address - Country:US
Practice Address - Phone:203-777-8001
Practice Address - Fax:203-777-0873
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0008830183500000X
NY045762183500000X
KS1-10819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist