MEDICARE: DR. RAYMOND ANTHONY MASTRIANI R.PH, PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PR4555	ME

General Provider Information

NPI Number	:	1073513578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND ANTHONY MASTRIANI R.PH, PHARMD

Provider Business Mailing Address
First Line	:	65 HEATHER HILLS DR
Second Line	:
City	:	BRIDGEWATER
State	:	MA
Zip	:	02324-2143
Country	:	US
Telephone Number	:	617-571-0158
Fax Number	:	508-967-7083

Provider Business Practice Location Address
First Line	:	65 HEATHER HILLS DR
Second Line	:
City	:	BRIDGEWATER
State	:	MA
Zip	:	02324-2143
Country	:	US
Telephone Number	:	617-571-0158
Fax Number	:	508-967-7083

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	03/09/2009

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