Healthcare Provider Details

I. General information

NPI: 1205705415
Provider Name (Legal Business Name): KEVIN ESCANO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 HIGHLAND AVE
WINCHESTER MA
01890-1496
US

IV. Provider business mailing address

415 PROSPECT ST
NORWELL MA
02061-1114
US

V. Phone/Fax

Practice location:
  • Phone: 781-756-2391
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH240517
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: