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Ethan Norin Chan
Student in an Organized Health Care Education/Training Program in New London, Connecticut
NPI 1679210694

Ethan Norin Chan is a Student in an Organized Health Care Education/Training Program based in Waterford, CT. Ethan Norin Chan practices in New London, CT. The NPI Number for Ethan Norin Chan is 1679210694 and holds a License No. PTT15131 (Connecticut).

The current practice location address for Ethan Norin Chan is 698 Bank St, New London, CT and can be reached out via phone at 860-772-9334. You can also correspond with Ethan Norin Chan through the mailing address at 58 KENYON RD, WATERFORD, CT - 06385-4214 (mailing address contact number: ).

Location: 698 Bank St, New London, CT, 06385-4214
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1679210694
Provider Name
Ethan Norin Chan
Credential
Provider Entity Type
Individual
Gender
Male
Address
698 Bank St, New London, CT, 06385-4214
Phone Number
860-772-9334
Fax Number
Provider Enumeration Date
05/20/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
698 Bank St
City
New London
State
Connecticut
Zip
06320-5040
Phone Number
860-772-9334
Fax Number
person
Provider Business Mailing Address Details
Address
58 Kenyon Rd
City
Waterford
State
Connecticut
Zip
06385-4214
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Pharmacy Service Providers
Classification
Pharmacy Technician
Speciality
-
Taxonomy
183700000X
License No.
PI167939 (Massachusetts)
Definition
A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
PTT15131 (Massachusetts)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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