Healthcare Provider Details

I. General information

NPI: 1326961558
Provider Name (Legal Business Name): SUSAN AMY BORNSTEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 LINCOLN ST
FRAMINGHAM MA
01702-6342
US

IV. Provider business mailing address

8 TRAYER RD
CANTON MA
02021-3808
US

V. Phone/Fax

Practice location:
  • Phone: 508-383-8252
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH22678
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: