Individual
KATHRYN DEDOMINICIS LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S, PHARM.D., BCGP
Contact information
Practice address
940 BELMONT ST, BROCKTON, MA 02301
(774) 826-2181
Mailing address
108 MAPLE ST, MILTON, MA 02186-2226
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26476
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639287337
VA
—
Enumeration date
08/25/2006
Last updated
06/01/2018
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