Healthcare Provider Details

I. General information

NPI: 1336494566
Provider Name (Legal Business Name): DANIELLE F CIUFFETELLI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 07/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 LOISDALE CT
SPRINGFIELD VA
22150-1826
US

IV. Provider business mailing address

2727 S QUINCY ST APT. 312
ARLINGTON VA
22206-2354
US

V. Phone/Fax

Practice location:
  • Phone: 610-425-0300
  • Fax:
Mailing address:
  • Phone: 610-425-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0202211404
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: