Provider Demographics
NPI:1962910638
Name:BALICKI, ASHLEE E (RPH)
Entity type:Individual
Prefix:DR
First Name:ASHLEE
Middle Name:E
Last Name:BALICKI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 WEST ST
Mailing Address - Street 2:
Mailing Address - City:WARE
Mailing Address - State:MA
Mailing Address - Zip Code:01082-1415
Mailing Address - Country:US
Mailing Address - Phone:413-967-5371
Mailing Address - Fax:
Practice Address - Street 1:139 WEST ST
Practice Address - Street 2:
Practice Address - City:WARE
Practice Address - State:MA
Practice Address - Zip Code:01082-1415
Practice Address - Country:US
Practice Address - Phone:413-967-5371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH237657183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist