Provider Demographics
NPI:1417234261
Name:SMITH, MAUREEN P (PH)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:P
Last Name:SMITH
Suffix:
Gender:F
Credentials:PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:683 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-2501
Mailing Address - Country:US
Mailing Address - Phone:781-329-4420
Mailing Address - Fax:781-329-3578
Practice Address - Street 1:683 HIGH ST
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-2501
Practice Address - Country:US
Practice Address - Phone:781-329-4420
Practice Address - Fax:781-329-3578
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH20264183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist