Provider Demographics
NPI:1447781257
Name:PALMER, LAI TING (RPH)
Entity Type:Individual
Prefix:MS
First Name:LAI TING
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-3050
Mailing Address - Country:US
Mailing Address - Phone:860-233-9673
Mailing Address - Fax:860-570-0066
Practice Address - Street 1:566 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-3050
Practice Address - Country:US
Practice Address - Phone:860-233-9673
Practice Address - Fax:860-570-0066
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0009206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist