Provider Demographics
NPI:1902214265
Name:CZECH, CHRISTOPHER L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:L
Last Name:CZECH
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 1:502 W RIVER RD
Mailing Address - Street 2:APT 63
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-1311
Mailing Address - Country:US
Mailing Address - Phone:518-852-2143
Mailing Address - Fax:
Practice Address - Street 1:502 W RIVER RD
Practice Address - Street 2:APT 63
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-1311
Practice Address - Country:US
Practice Address - Phone:518-852-2143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3979183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist