Provider Demographics
NPI:1831639442
Name:GIORNO, COSMO J (BS, RPH)
Entity Type:Individual
Prefix:MR
First Name:COSMO
Middle Name:J
Last Name:GIORNO
Suffix:
Gender:M
Credentials:BS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 ELM ST
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-4132
Mailing Address - Country:US
Mailing Address - Phone:860-388-6461
Mailing Address - Fax:860-388-5145
Practice Address - Street 1:105 ELM ST
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-4132
Practice Address - Country:US
Practice Address - Phone:860-388-6461
Practice Address - Fax:860-388-5145
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist