Provider Demographics
NPI:1528538394
Name:NAKHAEE, NEIMA (RPH)
Entity Type:Individual
Prefix:
First Name:NEIMA
Middle Name:
Last Name:NAKHAEE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 OVERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-2245
Mailing Address - Country:US
Mailing Address - Phone:781-929-6560
Mailing Address - Fax:
Practice Address - Street 1:137 W CENTRAL ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4310
Practice Address - Country:US
Practice Address - Phone:508-655-2271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH238334183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPH238334OtherMA DEPARTMENT OF PUBLIC HEALTH BOARD OF REGISTRATION IN PHARMACY