Provider Demographics
NPI:1699211318
Name:CARPINTERI, CARRIE CARMELA
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:CARMELA
Last Name:CARPINTERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-2710
Mailing Address - Country:US
Mailing Address - Phone:203-237-8984
Mailing Address - Fax:203-639-1365
Practice Address - Street 1:540 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-2710
Practice Address - Country:US
Practice Address - Phone:203-237-8984
Practice Address - Fax:203-639-1365
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9806183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist