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General NPI Number Information
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NPI Number | 1023431186
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Entity Type | Individual
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Provider Name | NAIMA FAZEL PHARMD, RPH
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Gender | Female
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 141 DEEPWOOD LN
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City | WALLINGFORD
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State | CT
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Zip | 06492-5507
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Country | US
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Telephone | 203-376-5499
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Fax |
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Provider Business Mailing Address
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Address Line | 141 DEEPWOOD LN
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City | WALLINGFORD
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State | CT
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Zip | 06492-5507
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Country | US
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Telephone | 203-376-5499
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PCT.0012671
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License Number State | CT
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