Provider Demographics
NPI:1891779153
Name:CICHOWSKI, GREGORY FELIX (RPH)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:FELIX
Last Name:CICHOWSKI
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 1:53 OLD TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06268-1347
Mailing Address - Country:US
Mailing Address - Phone:860-429-8269
Mailing Address - Fax:860-429-8269
Practice Address - Street 1:53 OLD TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06268-1347
Practice Address - Country:US
Practice Address - Phone:860-429-8269
Practice Address - Fax:860-429-8269
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4837183500000X, 1835P1200X, 1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Not Answered1835P1300XPharmacy Service ProvidersPharmacistPsychiatric