Provider Demographics
NPI:1174128961
Name:DUHANYAN, SARKIS (RPH)
Entity type:Individual
Prefix:MR
First Name:SARKIS
Middle Name:
Last Name:DUHANYAN
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 1:45 BRIGHTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-8240
Mailing Address - Country:US
Mailing Address - Phone:617-699-8176
Mailing Address - Fax:
Practice Address - Street 1:181 BRIGHTON AVE
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-2007
Practice Address - Country:US
Practice Address - Phone:617-779-7313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH24781183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist