Provider Demographics
NPI:1700572823
Name:WEISS, EVELYN (RPH, BCPS)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:WEISS
Suffix:
Gender:F
Credentials:RPH, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BYFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01922-2821
Mailing Address - Country:US
Mailing Address - Phone:561-254-0632
Mailing Address - Fax:
Practice Address - Street 1:755 MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-2167
Practice Address - Country:US
Practice Address - Phone:978-557-2399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH2400991835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care