Provider Demographics
NPI:1740578558
Name:LABRIOLE, CHERYL M (RPH)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:M
Last Name:LABRIOLE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-5227
Mailing Address - Country:US
Mailing Address - Phone:860-447-0661
Mailing Address - Fax:
Practice Address - Street 1:280 BROAD ST
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-5227
Practice Address - Country:US
Practice Address - Phone:860-447-0661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0008868183500000X
RI03951183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist