Provider Demographics
NPI:1972823847
Name:BOSCARINO, PATRICK CHRISTOPHER (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:CHRISTOPHER
Last Name:BOSCARINO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 WOODRUFF ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-3356
Mailing Address - Country:US
Mailing Address - Phone:860-877-0259
Mailing Address - Fax:
Practice Address - Street 1:1350 STANLEY ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-3224
Practice Address - Country:US
Practice Address - Phone:860-224-7798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0011849183500000X
SC13144183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist