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Individual

IBRAHIM BOAKYE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
600 STATE ST, SPRINGFIELD, MA 01109-4104
(413) 736-0351
(413) 734-7037
Mailing address
600 STATE ST, SPRINGFIELD, MA 01109-4104
(413) 736-0351
(413) 734-7037

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH233465
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11008757561V
MA
Enumeration date
11/23/2020
Last updated
11/23/2020
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