Provider Demographics
NPI:1902227770
Name:CIURLEO, CORRADO R (RPH)
Entity Type:Individual
Prefix:MR
First Name:CORRADO
Middle Name:R
Last Name:CIURLEO
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 1:705 E 187TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-6803
Mailing Address - Country:US
Mailing Address - Phone:718-364-6100
Mailing Address - Fax:718-365-6421
Practice Address - Street 1:705 E 187TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-6803
Practice Address - Country:US
Practice Address - Phone:718-364-6100
Practice Address - Fax:718-365-6421
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-21
Last Update Date:2013-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038001183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist