Provider Demographics
NPI:1073953444
Name:DECHIARA, COLEEN O'BRIEN (RPH)
Entity Type:Individual
Prefix:
First Name:COLEEN
Middle Name:O'BRIEN
Last Name:DECHIARA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2214
Mailing Address - Country:US
Mailing Address - Phone:978-251-0529
Mailing Address - Fax:
Practice Address - Street 1:25 HAVEN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2930
Practice Address - Country:US
Practice Address - Phone:781-944-0633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH21826183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist