Provider Demographics
NPI:1275846677
Name:BUDILOVSKY-KELLEY, NATALIE ROZALIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:ROZALIE
Last Name:BUDILOVSKY-KELLEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 BENNINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-1134
Mailing Address - Country:US
Mailing Address - Phone:617-561-0610
Mailing Address - Fax:617-561-0739
Practice Address - Street 1:971 BENNINGTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-1134
Practice Address - Country:US
Practice Address - Phone:617-561-0610
Practice Address - Fax:617-561-0739
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH26427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist