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General NPI Number Information
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NPI Number | 1225639693
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Entity Type | Individual
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Provider Name | VIJAYA J GRACIAS
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Gender | Female
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 121 WORCESTER RD
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City | FRAMINGHAM
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State | MA
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Zip | 01701-5348
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Country | US
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Telephone | 508-872-4265
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Fax | 508-872-0314
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Provider Business Mailing Address
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Address Line | 23 STRATFORD RD
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City | NEWTON
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State | MA
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Zip | 02465-1816
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Country | US
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Telephone | 847-722-0414
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH232836
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License Number State | MA
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