Healthcare Provider Details

I. General information

NPI: 1003473406
Provider Name (Legal Business Name): FRANKLIN CHEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 YORK ST
NEW HAVEN CT
06510-3220
US

IV. Provider business mailing address

1199 WHITNEY AVE APT 424
HAMDEN CT
06517-2808
US

V. Phone/Fax

Practice location:
  • Phone: 203-200-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0014282
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: