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General NPI Number Information
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NPI Number | 1386923910
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Entity Type | Individual
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Provider Name | CHI CHUNG VICTOR FOK PH.D
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Gender | Male
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Dates
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Enumeration Date | 08/14/2011
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Last Update Date | 01/21/2022
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Provider Practice Location Address
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Address Line | 1300 WHALLEY AVE
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City | NEW HAVEN
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State | CT
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Zip | 06515-1101
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Country | US
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Telephone | 203-891-7031
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Fax | 203-891-7537
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Provider Business Mailing Address
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Address Line | 15 SQUIRE LN
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City | HAMDEN
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State | CT
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Zip | 06518-1417
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Country | US
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Telephone | 203-887-4267
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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.0010965
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License Number State | CT
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