Provider Demographics
NPI:1487275806
Name:PACLA, ROSEANNE POSADAS (RPH)
Entity type:Individual
Prefix:DR
First Name:ROSEANNE
Middle Name:POSADAS
Last Name:PACLA
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 1:229 WALNUT RD
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1530
Mailing Address - Country:US
Mailing Address - Phone:718-207-3629
Mailing Address - Fax:
Practice Address - Street 1:282 E 149TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5600
Practice Address - Country:US
Practice Address - Phone:718-665-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist