MEDICARE: ALEXANDER REECE TANGEN 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	1835I0206X	Infectious Diseases Pharmacist	PH1002331	MA

General Provider Information

NPI Number	:	1114819414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER REECE TANGEN PHARMD

Provider Business Mailing Address
First Line	:	126 BORDER ST UNIT 228
Second Line	:
City	:	EAST BOSTON
State	:	MA
Zip	:	02128-2076
Country	:	US
Telephone Number	:	816-665-7141
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 BROOKLINE AVE
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02215-5491
Country	:	US
Telephone Number	:	617-667-7000
Fax Number	:

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

Provider Enumeration Date	:	07/19/2025
Last Update Date	:	07/19/2025

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