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General NPI Number Information
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NPI Number | 1922539402
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Entity Type | Organization
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Legal Business Name | CVS PHARMACY
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Dates
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Enumeration Date | 03/25/2017
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Last Update Date | 03/25/2017
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Provider Practice Location Address
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Address Line | 123 WINDERMERE AVE
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City | GREENWOOD LAKE
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State | NY
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Zip | 10925-7000
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Country | US
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Telephone | 845-477-8024
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Fax |
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Provider Business Mailing Address
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Address Line | 714 GLEN WILD RD
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City | WOODRIDGE
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State | NY
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Zip | 12789-5011
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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 | PHARMACIST
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Name | DR. VANESSA PISELLI
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Credential | PHARMD,RPH
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Telephone | 845-798-9289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 061910
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License Number State | NY
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