Provider Demographics
NPI:1649564683
Name:MASSE, DARREN ELI (RPH)
Entity Type:Individual
Prefix:MR
First Name:DARREN
Middle Name:ELI
Last Name:MASSE
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 1:367 RUSSELL ST
Mailing Address - Street 2:T-1839
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9456
Mailing Address - Country:US
Mailing Address - Phone:413-586-6681
Mailing Address - Fax:413-586-6681
Practice Address - Street 1:367 RUSSELL ST
Practice Address - Street 2:T-1839
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9456
Practice Address - Country:US
Practice Address - Phone:413-586-6681
Practice Address - Fax:413-586-6681
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH24956183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist