Individual
MARIAME FOFANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 STAFFORD RD, FALL RIVER, MA 02721-2506
(508) 679-9600
Mailing address
10 STAFFORD RD, FALL RIVER, MA 02721-2506
(508) 679-9600
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PCT.0016101
CT
183500000X
Pharmacist
Primary
PH241205
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08142020
IMMUNIZATION
MA
Enumeration date
01/09/2023
Last updated
01/09/2023
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