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General NPI Number Information
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NPI Number | 1861100414
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Entity Type | Individual
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Provider Name | DANIELLE GILLIS
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Gender | Female
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 11/14/2022
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Provider Practice Location Address
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Address Line | 210 BOSTON RD
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City | NORTH BILLERICA
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State | MA
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Zip | 01862-2309
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Country | US
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Telephone | 978-663-6616
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Fax |
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Provider Business Mailing Address
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Address Line | 796 DORCHESTER AVE
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City | BOSTON
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State | MA
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Zip | 02125-1161
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Country | US
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Telephone | 978-807-3766
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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 | PH240383
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License Number State | MA
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