Provider Demographics
NPI:1225460546
Name:INDERLIN, TAYLA KRYSTINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAYLA
Middle Name:KRYSTINE
Last Name:INDERLIN
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 1:1035 CAMBRIDGE ST
Mailing Address - Street 2:SUITE 23
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1057
Mailing Address - Country:US
Mailing Address - Phone:617-806-8540
Mailing Address - Fax:617-806-8575
Practice Address - Street 1:1035 CAMBRIDGE ST
Practice Address - Street 2:SUITE 23
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-1057
Practice Address - Country:US
Practice Address - Phone:617-806-8540
Practice Address - Fax:617-806-8575
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH2340121835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy