Individual
DIANA DEAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
51 5TH ST, LOWELL, MA 01850-2154
(978) 995-4125
Mailing address
51 5TH ST, LOWELL, MA 01850-2154
(978) 995-4125
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PT5935
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT10199
STATE OF NEW HAMPSHIRE
NH
01
—
PT5935
COMMONWEALTH OF MASSACHUSETTS
MA
Enumeration date
02/11/2016
Last updated
02/11/2016
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