Provider Demographics
NPI:1134306145
Name:VITUG, CZERIESA BONDOC (PHARM D)
Entity Type:Individual
Prefix:MS
First Name:CZERIESA
Middle Name:BONDOC
Last Name:VITUG
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 1:191 WILLOUGHBY ST
Mailing Address - Street 2:7D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5464
Mailing Address - Country:US
Mailing Address - Phone:347-453-5337
Mailing Address - Fax:
Practice Address - Street 1:1052 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2904
Practice Address - Country:US
Practice Address - Phone:646-282-0530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051979183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist