Provider Demographics
NPI:1548555923
Name:SIERRA, NOEMI (RPH)
Entity Type:Individual
Prefix:
First Name:NOEMI
Middle Name:
Last Name:SIERRA
Suffix:
Gender:F
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:CENTRO COMERCIAL NORTE SHOPPING
Mailing Address - Street 2:WALGRRENS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00979-0000
Mailing Address - Country:US
Mailing Address - Phone:787-721-7111
Mailing Address - Fax:
Practice Address - Street 1:AVE. BARDORIOTY DE CASTRO 12663
Practice Address - Street 2:NORTE SHOPPING CENTER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-727-7111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist