Individual
BIANCA A CARABALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
55 WESTCHESTER SQ, BRONX, NY 10461-3525
(718) 239-6149
Mailing address
55 WESTCHESTER SQ, BRONX, NY 10461-3525
(718) 239-6149
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
036511
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036511
NYS LIC #
NY
Enumeration date
02/23/2010
Last updated
02/23/2010
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