Provider Demographics
NPI:1548459126
Name:CIMAGLIA, TINA M (RPH)
Entity type:Individual
Prefix:MS
First Name:TINA
Middle Name:M
Last Name:CIMAGLIA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:TINA
Other - Middle Name:M
Other - Last Name:OLIVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:680 CONNECTICUT AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854
Mailing Address - Country:US
Mailing Address - Phone:203-854-8519
Mailing Address - Fax:203-854-9526
Practice Address - Street 1:680 CONNECTICUT AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854
Practice Address - Country:US
Practice Address - Phone:203-854-8519
Practice Address - Fax:203-854-9526
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8950183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist