Individual
KELSEY LEIGH SHADICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 442-0711
Mailing address
2 KENLYN DR, ALBANY, NY 12205-1202
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0015185
CT
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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