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General NPI Number Information
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NPI Number | 1720698244
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Entity Type | Individual
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Provider Name | MELISSA CHINN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 55 PARK ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-5474
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Country | US
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Telephone | 316-305-7955
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Fax |
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Provider Business Mailing Address
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Address Line | 380 MATHER ST APT 6306
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City | HAMDEN
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State | CT
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Zip | 06514-3198
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Country | US
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Telephone | 316-305-7955
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 0202217917
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License Number State | VA
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