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General NPI Number Information
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NPI Number | 1316188634
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Entity Type | Individual
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Provider Name | CARLA M SOUSA PHARM D
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Gender | Female
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Dates
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Enumeration Date | 03/17/2009
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Last Update Date | 08/08/2016
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Provider Practice Location Address
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Address Line | 196 E HARTSDALE AVE
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City | HARTSDALE
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State | NY
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Zip | 10530-3505
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Country | US
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Telephone | 915-725-8890
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Fax |
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Provider Business Mailing Address
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Address Line | 12 PARK AVE
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City | ARDSLEY
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State | NY
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Zip | 10502-1622
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Country | US
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Telephone | 914-674-1201
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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 | 049471
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License Number State | NY
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