Provider Demographics
NPI:1275192825
Name:WELCHEK, CYNTHIA M (RPH, MS)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:WELCHEK
Suffix:
Gender:F
Credentials:RPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:YALE NEW HAVEN HOSPITAL
Mailing Address - Street 2:55 PARK STREET
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511
Mailing Address - Country:US
Mailing Address - Phone:203-688-7834
Mailing Address - Fax:
Practice Address - Street 1:YALE NEW HAVEN HOSPITAL
Practice Address - Street 2:55 PARK STREET
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511
Practice Address - Country:US
Practice Address - Phone:203-688-7834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.00059551835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N1003XPharmacy Service ProvidersPharmacistNutrition Support