Provider Demographics
NPI:1376650036
Name:MOTWANE, SEJAL R (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SEJAL
Middle Name:R
Last Name:MOTWANE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:78 LYMAN ST
Mailing Address - Street 2:UNIT #1
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452-5610
Mailing Address - Country:US
Mailing Address - Phone:617-972-5314
Mailing Address - Fax:617-972-5326
Practice Address - Street 1:485 ARSENAL ST
Practice Address - Street 2:HARVARD VANGUARD MEDICAL ASSOCIATES - PHARMACY ADMIN
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-5091
Practice Address - Country:US
Practice Address - Phone:617-972-5314
Practice Address - Fax:617-972-5326
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA25868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist