Provider Demographics
NPI:1841718970
Name:PABLA, SANDEEP KAUR
Entity type:Individual
Prefix:
First Name:SANDEEP
Middle Name:KAUR
Last Name:PABLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 MENOTOMY ROCKS DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-7815
Mailing Address - Country:US
Mailing Address - Phone:339-368-2854
Mailing Address - Fax:
Practice Address - Street 1:350 CAMBRIDGE RD
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6037
Practice Address - Country:US
Practice Address - Phone:781-933-4410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-09
Last Update Date:2017-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH237173183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPH237173OtherBOARD OF PHARMACY