Provider Demographics
NPI:1306220827
Name:LUDDY, CHELSEA ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ANN
Last Name:LUDDY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:ANN
Other - Last Name:LEITAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:40 HART ST
Mailing Address - Street 2:SUITE P
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052
Mailing Address - Country:US
Mailing Address - Phone:860-356-4401
Mailing Address - Fax:860-967-0176
Practice Address - Street 1:980 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06037-2219
Practice Address - Country:US
Practice Address - Phone:860-828-6844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0013394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist