Provider Demographics
NPI:1255337036
Name:MATIN, ARIF (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ARIF
Middle Name:
Last Name:MATIN
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 1:300 BIRNIE AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1121
Mailing Address - Country:US
Mailing Address - Phone:413-736-5649
Mailing Address - Fax:413-736-5099
Practice Address - Street 1:300 BIRNIE AVE
Practice Address - Street 2:STE 101
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1121
Practice Address - Country:US
Practice Address - Phone:413-736-5649
Practice Address - Fax:413-736-5099
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21591183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy