Healthcare Provider Details

I. General information

NPI: 1083537013
Provider Name (Legal Business Name): HIRA ILYAS PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 HAVERHILL ST
LAWRENCE MA
01841-2884
US

IV. Provider business mailing address

24 ESSEX ST UNIT 209
HAVERHILL MA
01832-5673
US

V. Phone/Fax

Practice location:
  • Phone: 978-686-0090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH1003919
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: