Provider Demographics
NPI:1295720084
Name:BEDROSIAN-GREGORIAN, CANDACE MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:MARIE
Last Name:BEDROSIAN-GREGORIAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BLUEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-1235
Mailing Address - Country:US
Mailing Address - Phone:978-251-7439
Mailing Address - Fax:
Practice Address - Street 1:3 BLUEBERRY LN
Practice Address - Street 2:
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-1235
Practice Address - Country:US
Practice Address - Phone:978-251-7439
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA194931835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy