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Individual

EILEEN MARY TICHY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PAC RD

Contact information

Practice address
2 CHURCH ST S, SUITE 401, NEW HAVEN, CT 06519-1717
(203) 785-5192
Mailing address
155 TALCOTT RD, GUILFORD, CT 06437-5001
(203) 204-2398

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
PENDING
CT
363AM0700X
Medical Physician Assistant
Primary
001042
CT

Other

Enumeration date
10/31/2006
Last updated
04/01/2011
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