Provider Demographics
NPI:1528319522
Name:LEVESQUE, AMY ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:ANN
Last Name:LEVESQUE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 BOYLSTON ST UNIT 406
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5506
Mailing Address - Country:US
Mailing Address - Phone:207-951-2993
Mailing Address - Fax:
Practice Address - Street 1:1249 BOYLSTON ST
Practice Address - Street 2:SUITE 328
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3417
Practice Address - Country:US
Practice Address - Phone:617-264-3000
Practice Address - Fax:617-264-3011
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH234269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist