Individual
ERIC NFORMI NDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
653 SQUIRE RD, REVERE, MA 02151-1866
(781) 289-0651
(781) 289-1573
Mailing address
653 SQUIRE RD, REVERE, MA 02151-1866
(781) 289-0651
(781) 289-1573
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH25652
MA
Other
Enumeration date
07/12/2010
Last updated
07/12/2010
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