Provider Demographics
NPI:1619693496
Name:BADRIKIAN, RAFFI (PHARMD)
Entity Type:Individual
Prefix:
First Name:RAFFI
Middle Name:
Last Name:BADRIKIAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2639
Mailing Address - Country:US
Mailing Address - Phone:617-783-2577
Mailing Address - Fax:
Practice Address - Street 1:427 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2639
Practice Address - Country:US
Practice Address - Phone:617-783-2577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH240599183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist