Provider Demographics
NPI:1366178899
Name:MORTALI, ANNA (PHARMD, BCACP)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:MORTALI
Suffix:
Gender:F
Credentials:PHARMD, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 SANDERSON ST STE 201
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-2779
Mailing Address - Country:US
Mailing Address - Phone:413-773-2022
Mailing Address - Fax:
Practice Address - Street 1:48 SANDERSON ST STE 201
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2779
Practice Address - Country:US
Practice Address - Phone:413-773-2130
Practice Address - Fax:413-773-4945
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH2404561835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care