Provider Demographics
NPI:1447717996
Name:CHARNECO, EILEEN (PHARMD)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:CHARNECO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 AVE ROBERTO H TODD
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-4807
Mailing Address - Country:US
Mailing Address - Phone:787-945-7710
Mailing Address - Fax:
Practice Address - Street 1:700 AVE ROBERTO H TODD
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-4807
Practice Address - Country:US
Practice Address - Phone:787-945-7710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-20
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist