Provider Demographics
NPI:1457839565
Name:BIALONCZYK, DAMIAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAMIAN
Middle Name:
Last Name:BIALONCZYK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-2377
Mailing Address - Country:US
Mailing Address - Phone:978-501-3963
Mailing Address - Fax:
Practice Address - Street 1:155 NORTHBORO RD
Practice Address - Street 2:
Practice Address - City:SOUTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01772-1033
Practice Address - Country:US
Practice Address - Phone:508-481-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH236378183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist