Healthcare Provider Details

I. General information

NPI: 1790176196
Provider Name (Legal Business Name): CHELSEA PAPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2015
Last Update Date: 02/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 UNIVERSAL DR N
NORTH HAVEN CT
06473-3156
US

IV. Provider business mailing address

200 UNIVERSAL DR N
NORTH HAVEN CT
06473-3156
US

V. Phone/Fax

Practice location:
  • Phone: 203-859-3491
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberPTN.0017060
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: