Healthcare Provider Details

I. General information

NPI: 1518469840
Provider Name (Legal Business Name): TARA KATHLEEN LECH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 MALL RD
BURLINGTON MA
01805-0001
US

IV. Provider business mailing address

31 MALL RD
BURLINGTON MA
01805-0001
US

V. Phone/Fax

Practice location:
  • Phone: 781-901-5202
  • Fax:
Mailing address:
  • Phone: 781-901-5202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number26820
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26820
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: