Healthcare Provider Details

I. General information

NPI: 1851051593
Provider Name (Legal Business Name): KULWANT GILL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2021
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 JACKSON ST
LOWELL MA
01852-2103
US

IV. Provider business mailing address

3 SCHIAPPA CIR
STONEHAM MA
02180
US

V. Phone/Fax

Practice location:
  • Phone: 978-805-1004
  • Fax:
Mailing address:
  • Phone: 617-501-0046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH24503
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: