Provider Demographics
NPI:1427362573
Name:JEAN-LAURENT, ADJOAVI (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ADJOAVI
Middle Name:
Last Name:JEAN-LAURENT
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 1:935 ANDOVER ST
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-1055
Mailing Address - Country:US
Mailing Address - Phone:978-851-6331
Mailing Address - Fax:
Practice Address - Street 1:935 ANDOVER ST
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-1055
Practice Address - Country:US
Practice Address - Phone:978-851-6331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-31
Last Update Date:2010-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22943183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist