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Individual
SUZANNE LYNN IACOVELLI
Active
Individual
SUZANNE LYNN IACOVELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
060383
NY
183500000X
Pharmacist
Primary
21688
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578854139
WEGMANS PHARMACY
MD
01
—
5555555555555
N/A
MD
Enumeration date
11/18/2018
Last updated
11/18/2018
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