Individual
KELSEY FONTNEAU MAYTAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
555 WILLARD AVE, NEWINGTON, CT 06111-2631
(860) 666-6951
Mailing address
555 WILLARD AVE, NEWINGTON, CT 06111-2631
(860) 666-6951
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
00144572716275960000
CT
Other
Enumeration date
09/04/2018
Last updated
01/11/2024
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