Individual
JESSIE LOREN COVIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
2850 ROUTE 112, MEDFORD, NY 11763-1404
(631) 696-4018
(631) 696-4074
Mailing address
2850 ROUTE 112, MEDFORD, NY 11763-1404
(631) 696-4018
(631) 696-4074
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
440101080555806
NY
Other
Enumeration date
09/15/2014
Last updated
09/15/2014
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