Healthcare Provider Details

I. General information

NPI: 1225352750
Provider Name (Legal Business Name): ROBERT CARMINE ACCETTA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2010
Last Update Date: 03/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 PALISADE AVE
BRONX NY
10471-1205
US

IV. Provider business mailing address

5901 PALISADE AVE
BRONX NY
10471-1205
US

V. Phone/Fax

Practice location:
  • Phone: 718-581-1213
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number36842
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: