Provider Demographics
NPI:1811344500
Name:PICKEL, KAREN (PHARMD, CGP, CDP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PICKEL
Suffix:
Gender:F
Credentials:PHARMD, CGP, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 WILCOX LN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06480-1002
Mailing Address - Country:US
Mailing Address - Phone:860-573-3324
Mailing Address - Fax:
Practice Address - Street 1:35 WILCOX LN
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:CT
Practice Address - Zip Code:06480-1002
Practice Address - Country:US
Practice Address - Phone:860-573-3324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.101541835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric