Provider Demographics
NPI:1295153542
Name:PALIOTTI, JUDITH (RPH)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:PALIOTTI
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 1:420 FUN CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:SURF CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28445
Mailing Address - Country:US
Mailing Address - Phone:910-803-6003
Mailing Address - Fax:
Practice Address - Street 1:420 FUN CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:SURF CITY
Practice Address - State:NC
Practice Address - Zip Code:28445
Practice Address - Country:US
Practice Address - Phone:910-803-6003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10296183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist