Individual
MICHAEL P KIPPENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 BROADWAY, 1116, MALDEN, MA 02148-2077
(617) 416-4630
Mailing address
500 BROADWAY, 1116, MALDEN, MA 02148-2077
(617) 416-4630
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26163
MA
183500000X
Pharmacist
PCT 9706
CT
Other
Enumeration date
08/31/2015
Last updated
08/31/2015
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