Provider Demographics
NPI:1649740051
Name:HAUSSER, CHRISTOPHER DANIEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DANIEL
Last Name:HAUSSER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 RYEGATE TER
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-7658
Mailing Address - Country:US
Mailing Address - Phone:732-986-3135
Mailing Address - Fax:
Practice Address - Street 1:99 HAWLEY LN
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-1202
Practice Address - Country:US
Practice Address - Phone:732-986-3135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0010473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist