Individual
MEHDI IBNOULKHATIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
910 WOLCOTT ST, WATERBURY, CT 06705-1317
(203) 759-1637
(203) 759-1843
Mailing address
910 WOLCOTT ST, WATERBURY, CT 06705-1317
(203) 759-1637
(203) 759-1843
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0011244
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000000
00000000000000
CT
Enumeration date
04/26/2018
Last updated
04/26/2018
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