Provider Demographics
NPI:1477724268
Name:TRANQUILINO, CARMENCITA J (RPH)
Entity type:Individual
Prefix:MS
First Name:CARMENCITA
Middle Name:J
Last Name:TRANQUILINO
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 1:1276 FULTON AVENUE
Mailing Address - Street 2:PHARMACY- 6TH FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-0000
Mailing Address - Country:US
Mailing Address - Phone:718-901-6260
Mailing Address - Fax:718-293-8315
Practice Address - Street 1:1276 FULTON AVE
Practice Address - Street 2:PHARMACY- 6TH FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-3402
Practice Address - Country:US
Practice Address - Phone:718-901-6260
Practice Address - Fax:718-293-8315
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00032037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist