Healthcare Provider Details

I. General information

NPI: 1982104451
Provider Name (Legal Business Name): CARMELA CARROZZA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2018
Last Update Date: 02/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 N SALEM RD
CROSS RIVER NY
10518-1104
US

IV. Provider business mailing address

299 JAY ST
KATONAH NY
10536-3706
US

V. Phone/Fax

Practice location:
  • Phone: 914-763-3152
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number063867
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: