Healthcare Provider Details

I. General information

NPI: 1740495217
Provider Name (Legal Business Name): KAREN LYNN RADWANSKI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 MANCHESTER ST STE 5A
CONCORD NH
03301-5101
US

IV. Provider business mailing address

117 MANCHESTER ST STE 5A
CONCORD NH
03301-5101
US

V. Phone/Fax

Practice location:
  • Phone: 603-606-9357
  • Fax: 603-217-2075
Mailing address:
  • Phone: 603-606-9357
  • Fax: 603-217-2075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number4151053
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3021
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number4151053
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: