Individual
MS. ANNMARIE IADEVAIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
961-3 PT. WASHINGTON BLVD, PORT WASHINGTON, NY 11050
(516) 944-6148
(516) 767-7961
Mailing address
961-3 PT. WASHINGTON BLVD, PORT WASHINGTON, NY 11050
(516) 944-6148
(516) 767-7961
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
037767
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00721875
—
NY
Enumeration date
12/10/2007
Last updated
12/10/2007
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