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General NPI Number Information
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NPI Number | 1164419974
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Entity Type | Individual
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Provider Name | PAUL PHILIP BELLIVEAU PHARM.D., R.PH
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Gender | Male
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 275 NICHOLS RD
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City | FITCHBURG
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State | MA
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Zip | 01420-1931
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Country | US
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Telephone | 978-665-5901
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Fax |
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Provider Business Mailing Address
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Address Line | 18 NATHANIEL DR
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City | HUDSON
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State | NH
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Zip | 03051-5075
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Country | US
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Telephone | 603-883-3906
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 21270
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License Number State | MA
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