Provider Demographics
NPI:1114642816
Name:PLEIL-PINO, TATIANA KARINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:KARINA
Last Name:PLEIL-PINO
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 1:4717 MESA ENCANTADA CT NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-3328
Mailing Address - Country:US
Mailing Address - Phone:505-908-4681
Mailing Address - Fax:
Practice Address - Street 1:4051 SOUTHERN BLVD SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-2069
Practice Address - Country:US
Practice Address - Phone:505-892-6690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00009752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist