=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265864516
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEKSANDRA KUDIN RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2013
-----------------------------------------------------
Last Update Date | 08/08/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15 SCHOOL ST
-----------------------------------------------------
City | FRAMINGHAM
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01701-7707
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-788-0604
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11 WARE ST
-----------------------------------------------------
City | LYNN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01902-1525
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-346-3501
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PH234804
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------