Provider Demographics
NPI:1528780566
Name:MONRREAL, VINCENT DAVEED (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:DAVEED
Last Name:MONRREAL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-4311
Mailing Address - Country:US
Mailing Address - Phone:617-497-5763
Mailing Address - Fax:
Practice Address - Street 1:16 BEACON ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-4311
Practice Address - Country:US
Practice Address - Phone:617-497-5763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH241088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist