Healthcare Provider Details

I. General information

NPI: 1932735818
Provider Name (Legal Business Name): HOURY LEBLEBJIAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 03/23/2020
Certification Date: 03/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BROOKLINE AVE
BOSTON MA
02215-5418
US

IV. Provider business mailing address

19 HARRIET AVE
BELMONT MA
02478-4414
US

V. Phone/Fax

Practice location:
  • Phone: 617-932-9206
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number253021
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: