Individual provider Active NPI

Annelise Eeckman, PHARMD

  • Pharmacist
  • Cambridge, MA
National Provider Identifier
1780410308
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH1002691 Issued in MA
Practice address
160 Cambridgepark Dr Unit 334
Cambridge, MA 02140-2464
Phone
(510) 345-7425
NPI assigned
Sep 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH1002691 MA Primary

Addresses

Primary practice location

160 Cambridgepark Dr Unit 334
Cambridge, MA 02140-2464

Mailing address

160 Cambridgepark Dr Unit 334
Cambridge, MA 02140-2464
Phone (510) 345-7425

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH1002691MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1780410308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 CAMBRIDGEPARK DR UNIT 334",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402464",
            "telephone_number": "510-345-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CAMBRIDGEPARK DR UNIT 334",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402464",
            "telephone_number": "510-345-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EECKMAN",
        "first_name": "ANNELISE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH1002691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.