Provider Demographics
NPI:1982071965
Name:ALKHALIL, WAEL GHASSAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:WAEL
Middle Name:GHASSAN
Last Name:ALKHALIL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-3310
Mailing Address - Country:US
Mailing Address - Phone:617-469-2658
Mailing Address - Fax:617-469-5676
Practice Address - Street 1:1999 CENTRE ST
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-3310
Practice Address - Country:US
Practice Address - Phone:617-469-2658
Practice Address - Fax:617-469-5676
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH236164183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist