Provider Demographics
NPI:1639485683
Name:SHAH, ROMIL D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROMIL
Middle Name:D
Last Name:SHAH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:41 AMATO DR
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-1943
Mailing Address - Country:US
Mailing Address - Phone:860-874-8631
Mailing Address - Fax:206-260-5904
Practice Address - Street 1:835 PARK AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2469
Practice Address - Country:US
Practice Address - Phone:860-242-5551
Practice Address - Fax:860-286-9076
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0011648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist