MEDICARE: DR. MICHELLE ANH TRAM LE RPH

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	PH240536	MA

General Provider Information

NPI Number	:	1821727835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE ANH TRAM LE RPH

Provider Business Mailing Address
First Line	:	2 WINTHROP ST APT 3
Second Line	:
City	:	WATERTOWN
State	:	MA
Zip	:	02472-1922
Country	:	US
Telephone Number	:	774-641-7128
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 BEACON ST
Second Line	:
City	:	NEWTON HIGHLANDS
State	:	MA
Zip	:	02461-1101
Country	:	US
Telephone Number	:	617-332-6880
Fax Number	:

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

Provider Enumeration Date	:	06/06/2022
Last Update Date	:	06/06/2022

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