Provider Demographics
NPI:1497237283
Name:DADE-ESPOSITO, CLARISSA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CLARISSA
Middle Name:
Last Name:DADE-ESPOSITO
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 1:10558 FAULKNER RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2226
Mailing Address - Country:US
Mailing Address - Phone:301-377-2182
Mailing Address - Fax:
Practice Address - Street 1:9300 LAKESIDE BLVD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4953
Practice Address - Country:US
Practice Address - Phone:410-363-8066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist