Provider Demographics
NPI:1174510887
Name:MCINTYRE, SOPHIE M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIE
Middle Name:M
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CHARLOTTE RD
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-8220
Mailing Address - Country:US
Mailing Address - Phone:508-429-8506
Mailing Address - Fax:781-894-5421
Practice Address - Street 1:9 HOPE AVE
Practice Address - Street 2:EATON APOTHECARY
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-2741
Practice Address - Country:US
Practice Address - Phone:781-894-5400
Practice Address - Fax:781-894-5421
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist