Provider Demographics
NPI:1073391389
Name:TORIBIO, IRIS ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:ANN
Last Name:TORIBIO
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 1:153 NORTHEAST DR
Mailing Address - Street 2:
Mailing Address - City:ZIA PUEBLO
Mailing Address - State:NM
Mailing Address - Zip Code:87053-6017
Mailing Address - Country:US
Mailing Address - Phone:505-867-5485
Mailing Address - Fax:
Practice Address - Street 1:3 CEDAR STREET
Practice Address - Street 2:
Practice Address - City:SAN FELIPE PUEBLO
Practice Address - State:NM
Practice Address - Zip Code:87001
Practice Address - Country:US
Practice Address - Phone:505-867-5485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00009418183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist