MEDICARE: MICHELLE PACIA

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
1	183500000X	Pharmacist	067589	NY

General Provider Information

NPI Number	:	1710579834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE PACIA

Provider Business Mailing Address
First Line	:	2726 QUEENS PLZ S
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-4102
Country	:	US
Telephone Number	:	718-269-7385
Fax Number	:

Provider Business Practice Location Address
First Line	:	2726 QUEENS PLZ S
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-4102
Country	:	US
Telephone Number	:	718-269-7385
Fax Number	:	718-269-7386

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2021
Last Update Date	:	11/22/2022

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Directions to “ MICHELLE PACIA ” Practice Location

Language	Start Address	Practice Location

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