Provider Demographics
NPI:1851029607
Name:KHEN, PHIRIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:PHIRIN
Middle Name:
Last Name:KHEN
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 1:70 DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-3757
Mailing Address - Country:US
Mailing Address - Phone:860-866-6478
Mailing Address - Fax:
Practice Address - Street 1:425 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-3816
Practice Address - Country:US
Practice Address - Phone:203-639-8166
Practice Address - Fax:203-639-7207
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0016069183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist