Provider Demographics
NPI:1265764179
Name:ACEBEDO, FRANCINE SUSAN
Entity type:Individual
Prefix:
First Name:FRANCINE
Middle Name:SUSAN
Last Name:ACEBEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 WALT WHITMAN RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4159
Mailing Address - Country:US
Mailing Address - Phone:800-218-5604
Mailing Address - Fax:811-218-4924
Practice Address - Street 1:1660 WALT WHITMAN RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4159
Practice Address - Country:US
Practice Address - Phone:800-218-5604
Practice Address - Fax:811-218-4924
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030761183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist