Provider Demographics
NPI:1740616002
Name:RIBISI, MARIE SILVANA (PHARMACIST/ PHARMD)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:SILVANA
Last Name:RIBISI
Suffix:
Gender:F
Credentials:PHARMACIST/ PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 FROST POND ROAD
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542
Mailing Address - Country:US
Mailing Address - Phone:516-669-2762
Mailing Address - Fax:
Practice Address - Street 1:207 FROST POND RD
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-4048
Practice Address - Country:US
Practice Address - Phone:516-669-2762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0382781835P0018X
NJR0192191835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist