Provider Demographics
NPI:1538161088
Name:ZAIKEN, KATHY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KATHY
Middle Name:
Last Name:ZAIKEN
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 1:19 DRURY LN
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1713
Mailing Address - Country:US
Mailing Address - Phone:617-875-3467
Mailing Address - Fax:617-732-2244
Practice Address - Street 1:179 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5804
Practice Address - Country:US
Practice Address - Phone:617-732-2740
Practice Address - Fax:617-732-2244
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25237183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist