Provider Demographics
NPI:1407254592
Name:PUCCI, ROBIN LYN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:LYN
Last Name:PUCCI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:LYN
Other - Last Name:DANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:16228 CHIANTI AVE
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2574
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16228 CHIANTI AVE
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2574
Practice Address - Country:US
Practice Address - Phone:973-610-0646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54582183500000X
CARPH38248183500000X
NJRI01727300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist