Provider Demographics
NPI:1598299901
Name:LOR, CHENGYENG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHENGYENG
Middle Name:
Last Name:LOR
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 1:241 MIDDLE TPKE W
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-3834
Mailing Address - Country:US
Mailing Address - Phone:860-533-1156
Mailing Address - Fax:860-533-1428
Practice Address - Street 1:241 MIDDLE TPKE W
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-3834
Practice Address - Country:US
Practice Address - Phone:860-533-1156
Practice Address - Fax:860-533-1428
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0011321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist