Provider Demographics
NPI:1942926381
Name:CARLETON, SAMANTHA TAYLOR (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:TAYLOR
Last Name:CARLETON
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 HARVARD AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-4626
Mailing Address - Country:US
Mailing Address - Phone:631-365-2662
Mailing Address - Fax:
Practice Address - Street 1:16 BEACON ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-4311
Practice Address - Country:US
Practice Address - Phone:617-497-5783
Practice Address - Fax:617-497-5763
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH241189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist