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General NPI Number Information
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NPI Number | 1356155915
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Entity Type | Individual
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Provider Name | LOAN LE
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Gender | Female
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 99 HARVARD ST
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City | BROOKLINE
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State | MA
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Zip | 02446-6403
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Country | US
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Telephone | 617-731-4536
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Fax |
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Provider Business Mailing Address
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Address Line | 147 KELTON ST APT 606
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City | ALLSTON
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State | MA
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Zip | 02134-4385
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Country | US
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Telephone | 860-879-1422
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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 | PH1000268
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License Number State | MA
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