Provider Demographics
NPI:1336315506
Name:TASCIONE, ANTHONY (RPH)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:TASCIONE
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 1:15728 POLONIUS CT
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5694
Mailing Address - Country:US
Mailing Address - Phone:704-896-1053
Mailing Address - Fax:704-892-3809
Practice Address - Street 1:15728 POLONIUS CT
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-5694
Practice Address - Country:US
Practice Address - Phone:704-896-1053
Practice Address - Fax:704-892-3809
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16957183500000X, 1835N0905X
NY35610183500000X, 1835N0905X
FLPS26360183500000X
FLNP1471835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N0905XPharmacy Service ProvidersPharmacistNuclear