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General NPI Number Information
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NPI Number | 1093083495
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Entity Type | Individual
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Provider Name | JUANA ELIZABETH TEJADA PICHETTE DOCTOR OF PHARMACY
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Gender | Female
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 59 WATERFRONT PLAZA
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City | NEWPORT
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State | VT
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Zip | 05855
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Country | US
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Telephone | 802-808-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 59 COVENTRY ST UNIT 972
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City | NEWPORT
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State | VT
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Zip | 05855-2839
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS 44775
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License Number State | FL
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