1235483645 NPI number — DR. ELIZABETH MARY TOUFAS PHARMD

Table of content: DR. ELIZABETH MARY TOUFAS PHARMD (NPI 1235483645)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235483645 NPI number — DR. ELIZABETH MARY TOUFAS PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOUFAS
Provider First Name:
ELIZABETH
Provider Middle Name:
MARY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RUSSELL
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1235483645
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 CENTURY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WORCESTER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01606-1244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
744-420-3987
Provider Business Mailing Address Fax Number:
774-420-3986

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12 PLYMOUTH ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
WORCESTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01608-2121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-754-8800
Provider Business Practice Location Address Fax Number:
508-754-8878
Provider Enumeration Date:
11/07/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PH234500 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183500000X , with the licence number: PR6103 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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