Provider Demographics
NPI:1962625970
Name:COLON-OCASIO, MAGALY (RPH)
Entity type:Individual
Prefix:
First Name:MAGALY
Middle Name:
Last Name:COLON-OCASIO
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:P2 CALLE SAN CRISTOBAL
Mailing Address - Street 2:ALTURAS DE SAN PEDRO
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-5013
Mailing Address - Country:US
Mailing Address - Phone:787-863-5981
Mailing Address - Fax:
Practice Address - Street 1:300 CALLE FONT MARTELO
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3230
Practice Address - Country:US
Practice Address - Phone:787-852-0505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist