Provider Demographics
NPI:1154570513
Name:MUISE, EUGENE F JR (RPH,, MS,)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:F
Last Name:MUISE
Suffix:JR
Gender:M
Credentials:RPH,, MS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 SOLDIERS FIELD RD
Mailing Address - Street 2:MACIPA
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-1023
Mailing Address - Country:US
Mailing Address - Phone:617-259-2129
Mailing Address - Fax:617-259-2189
Practice Address - Street 1:1380 SOLDIERS FIELD RD
Practice Address - Street 2:MACIPA
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135-1023
Practice Address - Country:US
Practice Address - Phone:617-259-2129
Practice Address - Fax:617-259-2189
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist