Pymaneh Davalloo- Mansouri

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH25357 Issued in MA

Practice address

47 Pond St
Ashland, MA 01721-2054

Phone

(508) 872-4860

Fax

(508) 270-3979

NPI assigned

Nov 30, 2020

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 30, 2020.

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1992309918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 POND ST",
            "city": "ASHLAND",
            "state": "MA",
            "postal_code": "017212054",
            "telephone_number": "508-872-4860",
            "fax_number": "508-270-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 POND ST",
            "city": "ASHLAND",
            "state": "MA",
            "postal_code": "017212054",
            "telephone_number": "508-872-4860",
            "fax_number": "508-270-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVALLOO- MANSOURI",
        "first_name": "PYMANEH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH25357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Ashland, MA
• Pharmacist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.