Provider Demographics
NPI:1093315558
Name:DILUSTRO, DAVID SALVATORE II (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SALVATORE
Last Name:DILUSTRO
Suffix:II
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 LANG PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3005
Mailing Address - Country:US
Mailing Address - Phone:401-749-9110
Mailing Address - Fax:
Practice Address - Street 1:6210 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:LANDOVER HILLS
Practice Address - State:MD
Practice Address - Zip Code:20784-1308
Practice Address - Country:US
Practice Address - Phone:301-773-7596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214941183500000X
MD24388183500000X
DCPH100001784183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist