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NPI Code Detail

MEDICARE: DR. MATHEW ANTHONY LETIZIA PHARMD

MEDICARE: DR. MATHEW ANTHONY LETIZIA PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist18754-40WI
21835P2201XAmbulatory Care Pharmacist1875440WI
3183500000XPharmacist18754-40WI

General Provider Information

NPI Number : 1245722545
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATHEW ANTHONY LETIZIA PHARMD
Provider Business Mailing Address
First Line : 8537 W HAYES PL
Second Line :
City : WEST ALLIS
State : WI
Zip : 53227-2536
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 807 E. LAYTON AVE STE A
Second Line :
City : MILWAUKEE
State : WI
Zip : 53221-2426
Country : US
Telephone Number : 414-269-2536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2018
Last Update Date : 04/06/2026

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