Healthcare Provider Details

I. General information

NPI: 1821419359
Provider Name (Legal Business Name): STEVEN PAUL NACCARATO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2013
Last Update Date: 12/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 PASEO DE PERALTA
SANTA FE NM
87501-1857
US

IV. Provider business mailing address

4129 S MEADOWS RD APT 322
SANTA FE NM
87507-3064
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-8787
  • Fax:
Mailing address:
  • Phone: 505-982-8787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00007563
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: