Individual
IVAN FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
1298 COMMONWEALTH AVE APT 4, BOSTON, MA 02134-4019
(401) 430-0513
Mailing address
1298 COMMONWEALTH AVE APT 4, BOSTON, MA 02134-4019
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH1002948
MA
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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