Provider Demographics
NPI:1568755015
Name:DIDONA, PAUL A
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:DIDONA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 GERMANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5033
Mailing Address - Country:US
Mailing Address - Phone:203-797-0223
Mailing Address - Fax:203-797-1965
Practice Address - Street 1:30 GERMANTOWN RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5033
Practice Address - Country:US
Practice Address - Phone:203-797-0223
Practice Address - Fax:203-797-1965
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0009940183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist