Provider Demographics
NPI:1376267195
Name:PICHARDO DE LA CRUZ, ANGELICA YARI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANGELICA
Middle Name:YARI
Last Name:PICHARDO DE LA CRUZ
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 1:8 HACIENDA MARGARITA CALLE INGENIO
Mailing Address - Street 2:
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773
Mailing Address - Country:US
Mailing Address - Phone:787-638-0000
Mailing Address - Fax:
Practice Address - Street 1:CARR #3 KM 28.0 RIO GRANDE PLAZA BO. ZARZAL
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-0074
Practice Address - Country:US
Practice Address - Phone:787-717-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist