Provider Demographics
NPI:1376184044
Name:JAIN, ANJORI (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANJORI
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 GREENWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:CT
Mailing Address - Zip Code:06483-2462
Mailing Address - Country:US
Mailing Address - Phone:203-305-9651
Mailing Address - Fax:
Practice Address - Street 1:45 GREENWOOD CIR
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:CT
Practice Address - Zip Code:06483-2462
Practice Address - Country:US
Practice Address - Phone:203-305-9651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0014622183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist