Healthcare Provider Details

I. General information

NPI: 1245163922
Provider Name (Legal Business Name): AZIZA GILLIGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 VARNUM AVE
LOWELL MA
01854-2134
US

IV. Provider business mailing address

37 W MEADOW CT
MILFORD NH
03055-5028
US

V. Phone/Fax

Practice location:
  • Phone: 978-937-6275
  • Fax:
Mailing address:
  • Phone: 339-970-4340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH232604
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: