Provider Demographics
NPI:1437510328
Name:ZEWDIE, FESEHAYE
Entity Type:Individual
Prefix:DR
First Name:FESEHAYE
Middle Name:
Last Name:ZEWDIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:HANSON
Mailing Address - State:MA
Mailing Address - Zip Code:02341-1163
Mailing Address - Country:US
Mailing Address - Phone:781-293-0561
Mailing Address - Fax:
Practice Address - Street 1:476 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:HANSON
Practice Address - State:MA
Practice Address - Zip Code:02341-1163
Practice Address - Country:US
Practice Address - Phone:781-293-0561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-18
Last Update Date:2016-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH235925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist