Provider Demographics
NPI:1962013730
Name:AGUDOSI, CHRISTINE (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:AGUDOSI
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 1:1000 METROPOLITAN AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-1021
Mailing Address - Country:US
Mailing Address - Phone:617-990-7164
Mailing Address - Fax:
Practice Address - Street 1:1478 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2607
Practice Address - Country:US
Practice Address - Phone:781-444-5714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH239290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist