Provider Demographics
NPI:1811592744
Name:CHIN, KAITLYN MICHELLE (RPH)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:MICHELLE
Last Name:CHIN
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 1:427 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2639
Mailing Address - Country:US
Mailing Address - Phone:617-783-2577
Mailing Address - Fax:
Practice Address - Street 1:427 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2639
Practice Address - Country:US
Practice Address - Phone:617-783-2577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH239066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist