Provider Demographics
NPI:1578887758
Name:JEAN-BAPTISTE-CELISIE, KATTIA (PHARM D)
Entity Type:Individual
Prefix:
First Name:KATTIA
Middle Name:
Last Name:JEAN-BAPTISTE-CELISIE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 1/2 MILFORD AVE
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-5618
Mailing Address - Country:US
Mailing Address - Phone:203-612-1203
Mailing Address - Fax:
Practice Address - Street 1:394 CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-5012
Practice Address - Country:US
Practice Address - Phone:203-932-9311
Practice Address - Fax:203-933-6737
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10265183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist