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General NPI Number Information
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NPI Number | 1629920541
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Entity Type | Individual
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Provider Name | LORI-ANN IACOVINO
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Gender | Female
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 718 TEANECK RD
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City | TEANECK
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State | NJ
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Zip | 07666-4245
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Country | US
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Telephone | 201-833-3000
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Fax | 201-227-6058
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Provider Business Mailing Address
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Address Line | 9 ROSE ST
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City | WOOD RIDGE
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State | NJ
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Zip | 07075-2211
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Country | US
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Telephone | 201-424-5178
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Fax | 201-227-6058
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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 | 1835I0206X
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Taxonomy Name | Infectious Diseases Pharmacist
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License Number | 28RI02085200
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License Number State | NJ
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