Provider Demographics
NPI:1598820722
Name:ALDAR OF CONNECTICUT
Entity Type:Organization
Organization Name:ALDAR OF CONNECTICUT
Other - Org Name:MILFORD SURGICAL AND PHIL'S PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGOZZINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-874-1677
Mailing Address - Street 1:454 BRIDGEPORT AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4106
Mailing Address - Country:US
Mailing Address - Phone:203-874-1677
Mailing Address - Fax:203-874-4930
Practice Address - Street 1:454 BRIDGEPORT AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4106
Practice Address - Country:US
Practice Address - Phone:203-874-1677
Practice Address - Fax:203-874-4930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00970333600000X, 3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0155790001Medicare ID - Type Unspecified