Provider Demographics
NPI:1528212321
Name:SCHIAVETTA, DARIO JOHN (RPH)
Entity Type:Individual
Prefix:MR
First Name:DARIO
Middle Name:JOHN
Last Name:SCHIAVETTA
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 1:2134 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-4603
Mailing Address - Country:US
Mailing Address - Phone:718-204-6565
Mailing Address - Fax:718-545-7313
Practice Address - Street 1:2134 BROADWAY
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-4603
Practice Address - Country:US
Practice Address - Phone:718-204-6565
Practice Address - Fax:718-545-7313
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist