Jack Caloras, RPH

Individual provider Active NPI Geriatric Pharmacist · Montebello, NY

NPI 1376875401 · NPPES record last updated Jan 29, 2010

Key facts

NPI
1376875401
Entity type
Individual (NPI type 1)
Primary specialty
Geriatric Pharmacist 1835G0303X
License
0033978 (NY)
Practice address
14 Mills Rd
Montebello, NY 10901-3747
Phone
(845) 369-3621
NPI assigned
Jan 29, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI01671000NJMDGeriatric Pharmacist
0033978NYMDGeriatric Pharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Pharmacist 1835G0303X 0033978 NY Yes
Geriatric Pharmacist 1835G0303X 28RI01671000 NJ

Addresses

Primary practice location

14 Mills Rd
Montebello, NY 10901-3747

Mailing address

14 Mills Rd
Montebello, NY 10901-3747
Phone (845) 369-3621

Other providers in Montebello, NY

All providers in Montebello, NY · Geriatric Pharmacist in New York

Sources for this page

Verify at the official NPI Registry.