Individual
KELLY MAZZULLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 CHESTERFIELD RD, EAST LYME, CT 06333-1730
(860) 287-7877
Mailing address
15 CHESTERFIELD RD, EAST LYME, CT 06333-1730
(860) 287-7877
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7800
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1
CT
—
Enumeration date
12/01/2020
Last updated
12/01/2020
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