Provider Demographics
NPI:1972699585
Name:PACYNA, ANNIE SANCHEZ (RPH)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:SANCHEZ
Last Name:PACYNA
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 1:19 DAISY CIRCLE
Mailing Address - Street 2:
Mailing Address - City:FORESTVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06010
Mailing Address - Country:US
Mailing Address - Phone:860-582-5146
Mailing Address - Fax:
Practice Address - Street 1:19 DAISY CIRCLE
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:CT
Practice Address - Zip Code:06010
Practice Address - Country:US
Practice Address - Phone:860-582-5146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5128183500000X
PR2322183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist