Healthcare Provider Details

I. General information

NPI: 1174959936
Provider Name (Legal Business Name): NEVEEN A MAKRAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2013
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 ELYSE RD
MANSFIELD MA
02048-3315
US

IV. Provider business mailing address

30 ELYSE RD
MANSFIELD MA
02048-3315
US

V. Phone/Fax

Practice location:
  • Phone: 508-654-7873
  • Fax:
Mailing address:
  • Phone: 508-654-7873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH05276
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH234517
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: