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NPI Code Detail

MEDICARE: TED CHAN PHARMD

MEDICARE: TED CHAN PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPCT.0013760CT

General Provider Information

NPI Number : 1215388210
Entity Type Code : Individual
Provider Name (Legal Business Name) : TED CHAN PHARMD
Provider Business Mailing Address
First Line : 73 CHESTERFIELD AVE
Second Line :
City : WOLCOTT
State : CT
Zip : 06716-3227
Country : US
Telephone Number : 347-369-9336
Fax Number :
Provider Business Practice Location Address
First Line : 190 EAST AVE
Second Line :
City : NORWALK
State : CT
Zip : 06855-1112
Country : US
Telephone Number : 203-838-6141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2016
Last Update Date : 06/30/2016

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Directions to “ TED CHAN PHARMD” Practice Location

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