Provider Demographics
NPI:1558494484
Name:VALENZA, ANTHONY O (RPH, CDM, MTM)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:O
Last Name:VALENZA
Suffix:
Gender:M
Credentials:RPH, CDM, MTM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CRYSTAL ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-4001
Mailing Address - Country:US
Mailing Address - Phone:781-526-8284
Mailing Address - Fax:
Practice Address - Street 1:359 BROADWAY
Practice Address - Street 2:ROUTE 1
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-1905
Practice Address - Country:US
Practice Address - Phone:781-233-4991
Practice Address - Fax:781-233-2705
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20550183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist