Provider Demographics
NPI:1568231835
Name:TOMASELLO, AMY SUSAN (PHARMD, MPH, RPH)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:SUSAN
Last Name:TOMASELLO
Suffix:
Gender:F
Credentials:PHARMD, MPH, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 AUGUST LN
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01464-2633
Mailing Address - Country:US
Mailing Address - Phone:161-745-8990
Mailing Address - Fax:
Practice Address - Street 1:9 NELSON ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2131
Practice Address - Country:US
Practice Address - Phone:978-840-8343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22906183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist