MEDICARE: GITA KIAEE

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	PH1002973	MA

General Provider Information

NPI Number	:	1548127525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GITA KIAEE

Provider Business Mailing Address
First Line	:	704 CENTRE ST
Second Line	:
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-2516
Country	:	US
Telephone Number	:	617-524-4714
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 CENTRE ST
Second Line	:
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-2516
Country	:	US
Telephone Number	:	617-524-4714
Fax Number	:

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

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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Directions to “ GITA KIAEE ” Practice Location

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