Provider Demographics
NPI:1659341014
Name:MOZZACHIO, ALICIA (RPH)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:MOZZACHIO
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 1:2701 CALVERT ST NW
Mailing Address - Street 2:#825
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008
Mailing Address - Country:US
Mailing Address - Phone:202-248-7756
Mailing Address - Fax:301-827-8909
Practice Address - Street 1:11919 ROCKVILLE PIKE
Practice Address - Street 2:ROOM 415
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2784
Practice Address - Country:US
Practice Address - Phone:301-827-9010
Practice Address - Fax:301-827-8909
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040220L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist