Individual
AYSHA MANSOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
698 BANK ST, NEW LONDON, CT 06320-5040
(860) 440-3566
Mailing address
104 SANDY HOLLOW RD, MYSTIC, CT 06355-1718
(860) 961-5183
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0013702
CT
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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