Provider Demographics
NPI:1609156330
Name:LEVOSHKO, DANIELLE D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:D
Last Name:LEVOSHKO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MAIN ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-1869
Mailing Address - Country:US
Mailing Address - Phone:508-543-1779
Mailing Address - Fax:508-543-3044
Practice Address - Street 1:121 MAIN ST
Practice Address - Street 2:BLDG 6
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-1869
Practice Address - Country:US
Practice Address - Phone:508-543-1779
Practice Address - Fax:508-543-3044
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH27299183500000X
RIRPH04703183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist