Provider Demographics
NPI:1447551692
Name:TAPIA, PEGGY JOHANNA (PHARM D)
Entity type:Individual
Prefix:MISS
First Name:PEGGY
Middle Name:JOHANNA
Last Name:TAPIA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 MAMARONECK AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-3308
Mailing Address - Country:US
Mailing Address - Phone:914-949-0961
Mailing Address - Fax:
Practice Address - Street 1:24 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-3308
Practice Address - Country:US
Practice Address - Phone:914-949-0961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist