Provider Demographics
NPI:1134414626
Name:PERUGINI, JAMES III
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:PERUGINI
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-4068
Mailing Address - Country:US
Mailing Address - Phone:203-596-8192
Mailing Address - Fax:
Practice Address - Street 1:277 FAIRFIELD AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-4068
Practice Address - Country:US
Practice Address - Phone:203-596-8192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5793183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist