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NPI Code Detail

MEDICARE: DR. ANTHONY MARK ISHAK PHARM.D.

MEDICARE: DR. ANTHONY MARK ISHAK PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P2201XAmbulatory Care PharmacistPH26862MA

General Provider Information

NPI Number : 1376541003
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTHONY MARK ISHAK PHARM.D.
Provider Business Mailing Address
First Line : 131 FREEMAN ST
Second Line :
City : BROOKLINE
State : MA
Zip : 02446-3590
Country : US
Telephone Number : 408-813-6181
Fax Number :
Provider Business Practice Location Address
First Line : 440 FOLEY ST
Second Line :
City : SOMERVILLE
State : MA
Zip : 02145-1213
Country : US
Telephone Number : 857-282-0777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/15/2023

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