Healthcare Provider Details

I. General information

NPI: 1306756895
Provider Name (Legal Business Name): CAROLYN GRAHAM PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BROOKLINE AVE
BOSTON MA
02215-5491
US

IV. Provider business mailing address

1665 COMMONWEALTH AVE APT 8
BRIGHTON MA
02135-4900
US

V. Phone/Fax

Practice location:
  • Phone: 617-667-7000
  • Fax:
Mailing address:
  • Phone: 412-445-0523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP460382
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH1003642
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: