Healthcare Provider Details

I. General information

NPI: 1851237580
Provider Name (Legal Business Name): BANDER ASSIRI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6110
US

IV. Provider business mailing address

1260 BOYLSTON ST # 1201
BOSTON MA
02215-4445
US

V. Phone/Fax

Practice location:
  • Phone: 617-735-0949
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835I0206X
TaxonomyInfectious Diseases Pharmacist
License NumberPH997088
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: