Provider Demographics
NPI:1710163845
Name:VIOLA, ROBERTO (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:
Last Name:VIOLA
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 1:903 CLINTONVILLE ST
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1231
Mailing Address - Country:US
Mailing Address - Phone:718-767-7720
Mailing Address - Fax:
Practice Address - Street 1:903 CLINTONVILLE ST
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-1231
Practice Address - Country:US
Practice Address - Phone:718-767-7720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist