Provider Demographics
NPI:1295050425
Name:CHAMORRO, HILDA R
Entity type:Individual
Prefix:MS
First Name:HILDA
Middle Name:R
Last Name:CHAMORRO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:HILDA
Other - Middle Name:R
Other - Last Name:LAOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:1901 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-7404
Mailing Address - Country:US
Mailing Address - Phone:212-423-6555
Mailing Address - Fax:212-423-6661
Practice Address - Street 1:1901 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7404
Practice Address - Country:US
Practice Address - Phone:212-423-6555
Practice Address - Fax:212-423-6661
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045235-11835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist