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General NPI Number Information
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NPI Number | 1588260681
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Entity Type | Individual
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Provider Name | MARY E SIETINS RPH
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Gender | Female
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Dates
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Enumeration Date | 12/05/2020
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Last Update Date | 12/05/2020
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Provider Practice Location Address
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Address Line | 1470 S WASHINGTON ST
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City | N ATTLEBORO
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State | MA
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Zip | 02760-6745
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Country | US
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Telephone | 508-699-2007
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Fax |
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Provider Business Mailing Address
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Address Line | 8 MILL STREAM DR
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City | CUMBERLAND
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State | RI
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Zip | 02864-5425
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Country | US
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Telephone | 508-272-7834
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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 | PH19460
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License Number State | MA
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