Provider Demographics
NPI:1447849880
Name:GAJEWSKI, MARLENE ALMEIDA (RPH)
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:ALMEIDA
Last Name:GAJEWSKI
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 1:19 OSPREY DR
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02779-2337
Mailing Address - Country:US
Mailing Address - Phone:508-617-1909
Mailing Address - Fax:
Practice Address - Street 1:350 MYLES STANDISH BLVD STE 104
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-7387
Practice Address - Country:US
Practice Address - Phone:508-577-6112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI03465183500000X
MA21307183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist