Healthcare Provider Details

I. General information

NPI: 1346169554
Provider Name (Legal Business Name): CIARA MARRO-WILSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 NEVADA DR
NEW HYDE PARK NY
11042-1114
US

IV. Provider business mailing address

132 ALBERTA AVE
STATEN ISLAND NY
10314-4791
US

V. Phone/Fax

Practice location:
  • Phone: 917-932-3878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04452700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI072887
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: