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General NPI Number Information
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NPI Number | 1972647543
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Entity Type | Individual
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Provider Name | MR. JOHN JOSEPH CARESSIMO JR.
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Gender | Male
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 85 SANDY BOTTOM RD
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City | COVENTRY
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State | RI
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Zip | 02816-5863
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Country | US
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Telephone | 401-821-0600
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Fax | 401-823-7808
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Provider Business Mailing Address
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Address Line | 5 MARYLAND DR
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City | WEST WARWICK
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State | RI
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Zip | 02893-1213
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Country | US
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Telephone | 401-821-0600
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Fax | 401-823-7808
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | PHT01661
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License Number State | RI
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