Provider Demographics
NPI:1073291928
Name:JEAN-BAPTISTE, ANDREW I
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:I
Last Name:JEAN-BAPTISTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-5716
Mailing Address - Country:US
Mailing Address - Phone:978-840-9959
Mailing Address - Fax:978-840-9965
Practice Address - Street 1:35 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-5716
Practice Address - Country:US
Practice Address - Phone:978-840-9959
Practice Address - Fax:978-840-9965
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH234454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist