Provider Demographics
NPI:1609467273
Name:ZIRLIS, ROBERT S (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:S
Last Name:ZIRLIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 STONEWALL LN
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06413-2531
Mailing Address - Country:US
Mailing Address - Phone:860-969-4404
Mailing Address - Fax:
Practice Address - Street 1:10 FAIRFIELD BLVD UNIT C2
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-5903
Practice Address - Country:US
Practice Address - Phone:203-691-9619
Practice Address - Fax:203-815-1661
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT0008225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist