Healthcare Provider Details

I. General information

NPI: 1255337044
Provider Name (Legal Business Name): PAUL N ABOURJAILY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 WASHINGTON ST # 420
BOSTON MA
02111-1526
US

IV. Provider business mailing address

38 MONTEIRO WAY
NORTH ANDOVER MA
01845-5327
US

V. Phone/Fax

Practice location:
  • Phone: 617-636-0743
  • Fax:
Mailing address:
  • Phone: 978-258-3367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23841
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3827
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPR4621
License Number StateME
# 4
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number299101
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: