Provider Demographics
NPI:1811405111
Name:TEKIN, CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:TEKIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 HARVEST LN
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-1784
Mailing Address - Country:US
Mailing Address - Phone:203-767-6208
Mailing Address - Fax:
Practice Address - Street 1:1365 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-2755
Practice Address - Country:US
Practice Address - Phone:203-301-0570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-21
Last Update Date:2018-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8786333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy