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General NPI Number Information
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NPI Number | 1992987689
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Entity Type | Individual
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Provider Name | MAITE ASCASIBAR
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Gender | Female
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 12/04/2007
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Provider Practice Location Address
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Address Line | 2982 ROUTE 9
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City | VALATIE
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State | NY
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Zip | 12184-2515
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Country | US
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Telephone | 518-758-2200
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Fax | 518-758-2226
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Provider Business Mailing Address
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Address Line | 1 CVS DR BOX 1075- JULIE GIORDANO
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City | WOONSOCKET
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State | RI
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Zip | 02895-6146
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Country | US
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Telephone | 401-765-1500
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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 | 045680-1
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License Number State | NY
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