Provider Demographics
NPI:1467042176
Name:WHITNEY, WILLIAM GERARD JR
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GERARD
Last Name:WHITNEY
Suffix:JR
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 1:151R METHUEN ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01850-2109
Mailing Address - Country:US
Mailing Address - Phone:978-758-7465
Mailing Address - Fax:
Practice Address - Street 1:151R METHUEN ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01850-2109
Practice Address - Country:US
Practice Address - Phone:978-758-7465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16655183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist