Provider Demographics
NPI:1366828352
Name:HO, MELISSA (RPH)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HO
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 1:399 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1536
Mailing Address - Country:US
Mailing Address - Phone:617-658-6421
Mailing Address - Fax:617-658-6427
Practice Address - Street 1:399 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1536
Practice Address - Country:US
Practice Address - Phone:617-658-6421
Practice Address - Fax:617-658-6427
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH235995183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist