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NPI Code Detail

MEDICARE: EVARISTO RECINTO

MEDICARE:   EVARISTO  RECINTO
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
1183500000XPharmacistRP440324PA

General Provider Information

NPI Number : 1437436615
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVARISTO RECINTO
Provider Business Mailing Address
First Line : 1809 E ALLEGHENY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-3119
Country : US
Telephone Number : 215-426-0956
Fax Number :
Provider Business Practice Location Address
First Line : 1809 E ALLEGHENY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-3119
Country : US
Telephone Number : 215-426-0956
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2011
Last Update Date : 11/15/2011

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Directions to “ EVARISTO RECINTO ” Practice Location

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