Provider Demographics
NPI:1942966148
Name:PUCCINI, MELISSA MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:PUCCINI
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 1:2794 REDWING CT
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-8518
Mailing Address - Country:US
Mailing Address - Phone:513-505-2545
Mailing Address - Fax:
Practice Address - Street 1:7567 BRIDGETOWN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-2051
Practice Address - Country:US
Practice Address - Phone:513-941-4011
Practice Address - Fax:513-941-4016
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032152331835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care