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General NPI Number Information
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NPI Number | 1689791667
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Entity Type | Individual
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Provider Name | LISA M. ACQUISTA-OLIVIERI RPH
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Gender | Female
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 95 SCHOOL ST
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City | GLEN COVE
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State | NY
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Zip | 11542-2511
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Country | US
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Telephone | 516-676-9111
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Fax | 516-676-5162
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Provider Business Mailing Address
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Address Line | 1 WHITE CAP CT
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City | BAYVILLE
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State | NY
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Zip | 11709-1691
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Country | US
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Telephone | 516-802-3986
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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 | 042103
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License Number State | NY
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