Provider Demographics
NPI:1194020925
Name:CONTI, NICOLE ANN SPEREDELOZZI (PHARMD, BCPS, RPH)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:ANN SPEREDELOZZI
Last Name:CONTI
Suffix:
Gender:F
Credentials:PHARMD, BCPS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 AVENUE LOUIS PASTEUR
Mailing Address - Street 2:SUITE 216
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5727
Mailing Address - Country:US
Mailing Address - Phone:617-264-3000
Mailing Address - Fax:617-264-3011
Practice Address - Street 1:41 AVENUE LOUIS PASTEUR
Practice Address - Street 2:SUITE 216
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5727
Practice Address - Country:US
Practice Address - Phone:617-264-3000
Practice Address - Fax:617-264-3011
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA26792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist