Healthcare Provider Details

I. General information

NPI: 1265864516
Provider Name (Legal Business Name): ALEKSANDRA KUDIN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2013
Last Update Date: 08/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SCHOOL ST
FRAMINGHAM MA
01701-7707
US

IV. Provider business mailing address

11 WARE ST
LYNN MA
01902-1525
US

V. Phone/Fax

Practice location:
  • Phone: 508-788-0604
  • Fax:
Mailing address:
  • Phone: 781-346-3501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH234804
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: