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General NPI Number Information
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NPI Number | 1457823031
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Entity Type | Individual
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Provider Name | LAURA CACIOPPO PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/20/2018
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Last Update Date | 12/20/2018
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Provider Practice Location Address
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Address Line | 25 WATERFRONT PL
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City | PORT CHESTER
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State | NY
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Zip | 10573-6001
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Country | US
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Telephone | 914-937-7452
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Fax |
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Provider Business Mailing Address
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Address Line | 380 MOUNTAIN RD APT 209
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City | UNION CITY
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State | NJ
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Zip | 07087-7302
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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 | 062325
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License Number State | NY
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