Provider Demographics
NPI:1447974696
Name:PAPINGU, NERTILA (RPH)
Entity type:Individual
Prefix:
First Name:NERTILA
Middle Name:
Last Name:PAPINGU
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 1:63 SIERRA RD APT 7
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-2514
Mailing Address - Country:US
Mailing Address - Phone:857-389-7883
Mailing Address - Fax:781-352-6800
Practice Address - Street 1:80 WILSON WAY
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-1806
Practice Address - Country:US
Practice Address - Phone:813-526-5007
Practice Address - Fax:781-352-6800
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH240834183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist