Provider Demographics
NPI:1962793208
Name:DOYLE-STAINO, RITA-MARIE (RPH)
Entity type:Individual
Prefix:
First Name:RITA-MARIE
Middle Name:
Last Name:DOYLE-STAINO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 TYLER LAKE HTS
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:CT
Mailing Address - Zip Code:06756-1317
Mailing Address - Country:US
Mailing Address - Phone:860-491-5225
Mailing Address - Fax:
Practice Address - Street 1:76 MAIN ST
Practice Address - Street 2:
Practice Address - City:CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06018-2460
Practice Address - Country:US
Practice Address - Phone:860-824-5481
Practice Address - Fax:860-824-5794
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5766183500000X
SCPH12486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist