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General NPI Number Information
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NPI Number | 1295834398
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Entity Type | Individual
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Provider Name | LYNN P. GAVELEK RPH
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Gender | Female
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 555 WILLARD AVE
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City | NEWINGTON
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State | CT
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Zip | 06111-2631
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Country | US
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Telephone | 806-667-6843
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Fax | 860-667-6752
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Provider Business Mailing Address
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Address Line | 115 MISTY MOUNTAIN RD
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City | KENSINGTON
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State | CT
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Zip | 06037-2760
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Country | US
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Telephone | 860-828-8255
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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 | 5395
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License Number State | CT
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