NPI 1215787676

Mark Mikkelson, RPH

Practitioner Oncology Pharmacist Waterford, CT

Practice location

Address: 230 Waterford Pkwy S, Waterford, CT 06385-1219
Phone: (860) 271-4360

Registered specialties

Oncology Pharmacist Primary

Pharmacy Service Providers Taxonomy 1835X0200X Licence 5784 (CT)

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Registry record

NPI: 1215787676
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Mar 2024
Record last updated: 26 Mar 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.