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General NPI Number Information
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NPI Number | 1629100953
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Entity Type | Individual
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Provider Name | DONNA MARIE J COSENTINO PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 09/16/2007
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Provider Practice Location Address
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Address Line | 4650 HARRISON BLVD
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City | OGDEN
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State | UT
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Zip | 84403-4303
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Country | US
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Telephone | 801-479-4030
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Fax |
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Provider Business Mailing Address
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Address Line | 5795 CASSIE DR
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City | SOUTH OGDEN
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State | UT
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Zip | 84405-4843
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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 | 152818-1701
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License Number State | UT
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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 | 28RI01699100
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License Number State | NJ
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