Provider Demographics
NPI:1427542851
Name:KASSOS, MARIA K (RPH)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:K
Last Name:KASSOS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:MARIA
Other - Middle Name:K
Other - Last Name:FOTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:44 DEERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-1571
Mailing Address - Country:US
Mailing Address - Phone:508-410-9448
Mailing Address - Fax:
Practice Address - Street 1:44 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-1571
Practice Address - Country:US
Practice Address - Phone:508-410-9448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20190183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist