Provider Demographics
NPI:1760764997
Name:AGARWAL, ASHISH (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:ASHISH
Middle Name:
Last Name:AGARWAL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 FERRY STREET
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149
Mailing Address - Country:US
Mailing Address - Phone:617-389-2188
Mailing Address - Fax:617-389-3337
Practice Address - Street 1:317 FERRY STREET
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149
Practice Address - Country:US
Practice Address - Phone:617-389-2188
Practice Address - Fax:617-389-3337
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA25956183500000X
FLPS44742183500000X
GARPH025892183500000X
NJ28RI03241000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist