Provider Demographics
NPI:1427505130
Name:LIN, ERIC C (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:C
Last Name:LIN
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 1:250 BARNUM AVENUE CUTOFF
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-5152
Mailing Address - Country:US
Mailing Address - Phone:203-386-0550
Mailing Address - Fax:203-386-0821
Practice Address - Street 1:250 BARNUM AVENUE CUTOFF
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614
Practice Address - Country:US
Practice Address - Phone:203-395-0550
Practice Address - Fax:203-386-0821
Is Sole Proprietor?:No
Enumeration Date:2016-09-10
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0013199183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist