Provider Demographics
NPI:1295030088
Name:PUSZCZYNSKI, MARIUSZ (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:DR
First Name:MARIUSZ
Middle Name:
Last Name:PUSZCZYNSKI
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14125 STEELE CREEK RD
Mailing Address - Street 2:CVS PHARMACY
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-3968
Mailing Address - Country:US
Mailing Address - Phone:704-504-8199
Mailing Address - Fax:704-504-3496
Practice Address - Street 1:14125 STEELE CREEK RD
Practice Address - Street 2:CVS PHARMACY
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-3968
Practice Address - Country:US
Practice Address - Phone:704-504-8199
Practice Address - Fax:704-504-3496
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17420183500000X
SC010867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist