Provider Demographics
NPI:1649881699
Name:SPIEWAK, JEREMY KW (PHARMD, RPH, MSCS)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:KW
Last Name:SPIEWAK
Suffix:
Gender:M
Credentials:PHARMD, RPH, MSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 JOSEPH RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-7642
Mailing Address - Country:US
Mailing Address - Phone:508-981-5373
Mailing Address - Fax:
Practice Address - Street 1:67 S BEDFORD ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-5108
Practice Address - Country:US
Practice Address - Phone:508-981-5373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH236926183500000X, 1835P2201X
MI5302415202183500000X
VT033.0135009183500000X
NHPHCY-01545183500000X
MACDTM100000831835P0018X
MAMCS000162P1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist