Healthcare Provider Details

I. General information

NPI: 1356251953
Provider Name (Legal Business Name): KAITLIN LEWANDOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

91 SEAPORT BLVD
BOSTON MA
02210-2041
US

IV. Provider business mailing address

7 SCITUATE FARMS DR
CRANSTON RI
02921-1922
US

V. Phone/Fax

Practice location:
  • Phone: 857-350-4646
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH1003667
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: