Provider Demographics
NPI:1558966549
Name:MORALES, ALYSSA ANN (PHARMD)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:ANN
Last Name:MORALES
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 1:4 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-7914
Mailing Address - Country:US
Mailing Address - Phone:781-775-8967
Mailing Address - Fax:
Practice Address - Street 1:101 CANAL ST STE A
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-1807
Practice Address - Country:US
Practice Address - Phone:617-227-0720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH233024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist