Healthcare Provider Details

I. General information

NPI: 1609786284
Provider Name (Legal Business Name): MAYA ESTRELA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 CHESTNUT ST
SPRINGFIELD MA
01107-2011
US

IV. Provider business mailing address

461 HICKORY RD
NORTH ATTLEBORO MA
02760-6746
US

V. Phone/Fax

Practice location:
  • Phone: 413-271-9990
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH1003661
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: