David Deicicchi, PHARMD

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

PH232796 Issued in MA

Practice address

41 Avenue Louis Pasteur Ste 216
Boston, MA 02115-5727

Phone

(617) 264-5872

NPI assigned

Feb 3, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1740552835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 HANCOCK ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694339",
            "telephone_number": "617-264-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 AVENUE LOUIS PASTEUR STE 216",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155727",
            "telephone_number": "617-264-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEICICCHI",
        "first_name": "DAVID",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-03",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH232796",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "MA",
            "license": "PH232796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCSR",
            "identifier": "MD1123277P",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Degroot, MD
• Ella Marie Dehestani, PA-C
• Laura Deheulle
• Kerry Ann Dehimer, PA-C
• Mehrdad Dehpanah, D.M.D.
• Meghan Elizabeth Deighan, MSN CPNP-PC
• Ryan Deighan, DC
• Iris B Deitch Harel
• Annika Deitermann, MD
• Andre Dejam, MD, PHD

• Ambulatory Care Pharmacist in Boston, MA
• Providers in Boston, MA by specialty
• Ambulatory Care Pharmacist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.