Provider Demographics
NPI:1265102974
Name:FRROKU-DIDO, SINDORELA
Entity type:Individual
Prefix:
First Name:SINDORELA
Middle Name:
Last Name:FRROKU-DIDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:972 NEW HAVEN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-5713
Mailing Address - Country:US
Mailing Address - Phone:203-560-9198
Mailing Address - Fax:
Practice Address - Street 1:15 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:CT
Practice Address - Zip Code:06483-2809
Practice Address - Country:US
Practice Address - Phone:203-881-2756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0015575183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist