Maryellen Dascoli, PHARMD
Individual provider Active NPI Pharmacist · Methuen, MA
NPI 1982919569 · NPPES record last updated Aug 8, 2010
Key facts
- NPI
- 1982919569
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH26810 (MA)
- Practice address
- 176 Haverhill St
Methuen, MA 01844-3462 - Phone
- (978) 686-3058
- NPI assigned
- Aug 8, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH26810 | MA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH26810 | MA | Yes |
Addresses
Primary practice location
176 Haverhill St
Methuen, MA 01844-3462
Mailing address
176 Haverhill St
Methuen, MA 01844-3462
Phone (978) 686-3058
NPI Registry JSON
{
"created_epoch": "1281225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281225600000",
"number": "1982919569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "176 HAVERHILL ST",
"city": "METHUEN",
"state": "MA",
"postal_code": "018443462",
"telephone_number": "978-686-3058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "176 HAVERHILL ST",
"city": "METHUEN",
"state": "MA",
"postal_code": "018443462",
"telephone_number": "978-686-3058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DASCOLI",
"first_name": "MARYELLEN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-08",
"last_updated": "2010-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH26810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Methuen, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.