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Individual

DONNA MYCHASKIW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PD,MS

Contact information

Practice address
11 ABBOTT FARM RD, MIDDLEBURY, CT 06762-1213
(203) 758-9280
(203) 758-9280
Mailing address
11 ABBOTT FARM RD, P.O. BOX 1213, MIDDLEBURY, CT 06762-1213
(203) 758-9280
(203) 758-9280

Taxonomy

Speciality
Code
Description
License number
State
1835N1003X
Nutrition Support Pharmacist
Primary
6394
CT

Other

Enumeration date
12/01/2006
Last updated
07/08/2007
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