Individual
MI PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
575 PLEASANT ST, SOUTHINGTON, CT 06489-2711
(860) 970-5465
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
29334
MD
Other
Enumeration date
07/03/2024
Last updated
07/03/2024
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