Provider Demographics
NPI:1902267610
Name:CYR, KRISTEN LYN (RPH)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:LYN
Last Name:CYR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-4104
Mailing Address - Country:US
Mailing Address - Phone:203-235-4463
Mailing Address - Fax:203-235-0244
Practice Address - Street 1:172 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-4104
Practice Address - Country:US
Practice Address - Phone:203-235-4463
Practice Address - Fax:203-235-0244
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0008906183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist