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General NPI Number Information
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NPI Number | 1538695614
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Entity Type | Individual
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Provider Name | MCKENZIE RAGOSTA
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Gender | Female
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Dates
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Enumeration Date | 05/10/2017
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 873 NEW LOUDON RD
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City | LATHAM
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State | NY
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Zip | 12110-2150
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Country | US
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Telephone | 518-782-0227
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Fax |
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Provider Business Mailing Address
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Address Line | 873 NEW LOUDON RD
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City | LATHAM
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State | NY
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Zip | 12110-2150
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Country | US
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Telephone | 518-782-0227
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Fax | 866-301-3494
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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 | PH237329
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 069058
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License Number State | NY
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