Provider Demographics
NPI:1538652656
Name:TOMASTIK, CHERYL (RPH)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:TOMASTIK
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 1:215 GLASTONBURY BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4433
Mailing Address - Country:US
Mailing Address - Phone:860-659-5844
Mailing Address - Fax:
Practice Address - Street 1:215 GLASTONBURY BLVD STE 2
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4433
Practice Address - Country:US
Practice Address - Phone:860-659-5844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7704183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist