Provider Demographics
NPI:1497972681
Name:SHAUGHNESSEY, ANJA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANJA
Middle Name:
Last Name:SHAUGHNESSEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ANJA
Other - Middle Name:MARIA
Other - Last Name:SHAUGHNESSEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:705 MOUNT AUBURN ST
Mailing Address - Street 2:CLINICAL PHARMACY SERVICES MS 63
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-1508
Mailing Address - Country:US
Mailing Address - Phone:617-972-9411
Mailing Address - Fax:617-972-9543
Practice Address - Street 1:705 MOUNT AUBURN ST
Practice Address - Street 2:TUFTS HEALTH PLAN PHARMACY SERVICES MS 63
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-1508
Practice Address - Country:US
Practice Address - Phone:617-972-9411
Practice Address - Fax:617-972-9543
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25490183500000X
NH3328183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist