Individual
GINA ANN BENCIVENGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
250 FORTUNE BLVD, MILFORD, MA 01757-1743
(508) 478-5267
Mailing address
250 FORTUNE BLVD, MILFORD, MA 01757-1743
(508) 478-5267
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH25718
MA
183500000X
Pharmacist
RPH05075
RI
Other
Enumeration date
11/10/2011
Last updated
11/10/2011
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