Provider Demographics
NPI:1053577668
Name:KARVOSKY, EDMUND JR (PHARMACIST)
Entity type:Individual
Prefix:
First Name:EDMUND
Middle Name:
Last Name:KARVOSKY
Suffix:JR
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 GOVERNOR ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4687
Mailing Address - Country:US
Mailing Address - Phone:203-438-6600
Mailing Address - Fax:203-438-0305
Practice Address - Street 1:23 GOVERNOR ST
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4687
Practice Address - Country:US
Practice Address - Phone:203-438-6600
Practice Address - Fax:203-438-0305
Is Sole Proprietor?:No
Enumeration Date:2008-08-03
Last Update Date:2008-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE004199958Medicaid