Provider Demographics
NPI:1720230212
Name:KRUEGER-GRGURICH, LINDSEY A (PHARMD, BCACP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:A
Last Name:KRUEGER-GRGURICH
Suffix:
Gender:F
Credentials:PHARMD, BCACP
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:A
Other - Last Name:KRUEGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD, BCACP
Mailing Address - Street 1:752 WATERTOWN ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1035 CAMBRIDGE ST
Practice Address - Street 2:SUITE 23
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-1057
Practice Address - Country:US
Practice Address - Phone:617-806-8542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA26687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist