Provider Demographics
NPI:1316698442
Name:BOAKYE, KWABENA (RPH)
Entity type:Individual
Prefix:
First Name:KWABENA
Middle Name:
Last Name:BOAKYE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 WORCESTER RD APT P107
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8925
Mailing Address - Country:US
Mailing Address - Phone:774-946-5581
Mailing Address - Fax:
Practice Address - Street 1:57 ROLLSTONE RD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-5350
Practice Address - Country:US
Practice Address - Phone:978-342-8740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-11
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH240016183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist