Individual
LAURIE ANNE BELLIVEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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
PH25073
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110087561V
—
MA
05
—
1972640829
—
MA
Enumeration date
11/23/2020
Last updated
11/23/2020
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