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Individual
DR. MARY ANTONETTE EVANGELISTA CORDON
Active
Individual
DR. MARY ANTONETTE EVANGELISTA CORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202217006
VA
183500000X
Pharmacist
Primary
28RI03890300
NJ
183500000X
Pharmacist
PTP.0000548
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202217006
VIRGINIA BOARD OF PHARMACY
VA
01
—
28RI03890300
NEW JERSEY BOARD OF PHARMACY
NJ
01
—
PTP.0000548
CONNECTICUT BOARD OF PHARMACY
CT
Enumeration date
09/11/2020
Last updated
09/11/2020
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