Provider Demographics
NPI:1528669090
Name:WORTLEY, DOROTHEA JAYME (PHARMD)
Entity type:Individual
Prefix:
First Name:DOROTHEA
Middle Name:JAYME
Last Name:WORTLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 EXETER RD
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-2031
Mailing Address - Country:US
Mailing Address - Phone:603-767-6287
Mailing Address - Fax:
Practice Address - Street 1:59 WALTONS WAY
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1044
Practice Address - Country:US
Practice Address - Phone:603-692-7258
Practice Address - Fax:603-692-6041
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH234334183500000X
MEPR46528183500000X
NH3814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist