Provider Demographics
NPI:1326216532
Name:SCOLERI, NICOLINA MARIA (RPH)
Entity type:Individual
Prefix:MS
First Name:NICOLINA
Middle Name:MARIA
Last Name:SCOLERI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2043 AZALEA CT
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2748
Mailing Address - Country:US
Mailing Address - Phone:516-221-3056
Mailing Address - Fax:
Practice Address - Street 1:1686 MERRICK RD
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-4538
Practice Address - Country:US
Practice Address - Phone:516-378-9423
Practice Address - Fax:516-377-0887
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046747183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY046747OtherNY STATE LICENSE NUMBER