Provider Demographics
NPI:1265798557
Name:BARAYUGA, ANDREA (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:BARAYUGA
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 1:1 ARCHSTONE CIR
Mailing Address - Street 2:APT 404
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3790
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 LYNNFIELD ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-1424
Practice Address - Country:US
Practice Address - Phone:781-477-3250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2334041835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist