Provider Demographics
NPI:1437272762
Name:URRIOLA, CARLOS E (RPH)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:URRIOLA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 SPRING ST APT 20
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3756
Mailing Address - Country:US
Mailing Address - Phone:917-420-0341
Mailing Address - Fax:
Practice Address - Street 1:2039 SAINT PAUL AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3905
Practice Address - Country:US
Practice Address - Phone:917-929-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040101183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist