Provider Demographics
NPI:1831211390
Name:DANIELS, RICHARD R JR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:R
Last Name:DANIELS
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:55 FALLS LANDING RD
Mailing Address - Street 2:
Mailing Address - City:DEEP RIVER
Mailing Address - State:CT
Mailing Address - Zip Code:06417-1693
Mailing Address - Country:US
Mailing Address - Phone:860-227-0453
Mailing Address - Fax:860-526-7836
Practice Address - Street 1:55 FALLS LANDING RD
Practice Address - Street 2:
Practice Address - City:DEEP RIVER
Practice Address - State:CT
Practice Address - Zip Code:06417-1693
Practice Address - Country:US
Practice Address - Phone:860-227-0453
Practice Address - Fax:860-526-7836
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT61981835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric