Khadijat Ayinla

Individual provider Active NPI Pharmacist · Brookline, MA

NPI 1417670522 · NPPES record last updated Sep 22, 2022

Key facts

NPI
1417670522
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PH240980 (MA)
Practice address
294 Harvard St
Brookline, MA 02446-2917
Phone
(617) 731-6860
NPI assigned
Sep 22, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PH240980MAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH240980 MA Yes

Addresses

Primary practice location

294 Harvard St
Brookline, MA 02446-2917

Mailing address

294 Harvard St
Brookline, MA 02446-2917

Other providers in Brookline, MA

All providers in Brookline, MA · Pharmacist in Massachusetts

Sources for this page

Verify at the official NPI Registry.