MEDICARE: JESSICA DELLARAGIONE RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI02642500	NJ

General Provider Information

NPI Number	:	1366077752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA DELLARAGIONE RPH

Provider Business Mailing Address
First Line	:	31 PEGASUS DR
Second Line	:
City	:	TINTON FALLS
State	:	NJ
Zip	:	07724-2874
Country	:	US
Telephone Number	:	917-837-7466
Fax Number	:

Provider Business Practice Location Address
First Line	:	695 CENTRAL AVE STE 203
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-3662
Country	:	US
Telephone Number	:	866-234-4974
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2020
Last Update Date	:	03/06/2020

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