1215401781 NPI number — DR. CAROLINE MARIE PIZARRO PH.D.

Table of content: DR. CAROLINE MARIE PIZARRO PH.D. (NPI 1215401781)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215401781 NPI number — DR. CAROLINE MARIE PIZARRO PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIZARRO
Provider First Name:
CAROLINE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215401781
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CONDOMINIO LA PUNTILLA CALLE 4
Provider Second Line Business Mailing Address:
APT 155
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00901-1836
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-472-7247
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CONSOLIDATED MALL B5 ANNEX
Provider Second Line Business Practice Location Address:
202 GAUTIER BENITEZ AVE
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-704-0705
Provider Business Practice Location Address Fax Number:
787-744-7444
Provider Enumeration Date:
01/17/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  005850 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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