Provider Demographics
NPI:1225344971
Name:DILIBERTO, DANIELLE MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:DILIBERTO
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 1:25 BOHLING RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-2615
Mailing Address - Country:US
Mailing Address - Phone:315-790-1963
Mailing Address - Fax:
Practice Address - Street 1:1727 BLACK RIVER BLVD N
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-2425
Practice Address - Country:US
Practice Address - Phone:315-336-8890
Practice Address - Fax:315-339-6499
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054942183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist