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NPI Code Detail

MEDICARE: DR. LAURA CACIOPPO PHARMD

MEDICARE: DR. LAURA CACIOPPO PHARMD
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
1183500000XPharmacist062325NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1I062325OTHERNYNEW YORK STATE PHARMACIST LICENSE

General Provider Information

NPI Number : 1457823031
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURA CACIOPPO PHARMD
Provider Business Mailing Address
First Line : 380 MOUNTAIN RD APT 209
Second Line :
City : UNION CITY
State : NJ
Zip : 07087-7302
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 25 WATERFRONT PL
Second Line :
City : PORT CHESTER
State : NY
Zip : 10573-6001
Country : US
Telephone Number : 914-937-7452
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2018
Last Update Date : 12/20/2018

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