Healthcare Provider Details

I. General information

NPI: 1891246591
Provider Name (Legal Business Name): CHRISTINE STELLA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 THOMPSON RD
EAST WINDSOR CT
06088-9626
US

IV. Provider business mailing address

179 SCRANTON ST
NEW HAVEN CT
06511-5218
US

V. Phone/Fax

Practice location:
  • Phone: 860-623-3000
  • Fax:
Mailing address:
  • Phone: 860-539-4489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0008970
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: