Provider Demographics
NPI:1881116986
Name:LENTNER, DARRELL (PHARMD)
Entity type:Individual
Prefix:
First Name:DARRELL
Middle Name:
Last Name:LENTNER
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 1:155 WINDERMERE AVE UNIT 206
Mailing Address - Street 2:
Mailing Address - City:ELLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06029-5802
Mailing Address - Country:US
Mailing Address - Phone:860-878-5926
Mailing Address - Fax:
Practice Address - Street 1:10 PITKIN RD
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-4709
Practice Address - Country:US
Practice Address - Phone:860-871-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9609183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist