Lisa Bucco, RPH
Individual provider Active NPI Pharmacist · Waldwick, NJ
NPI 1497030191 · NPPES record last updated Oct 14, 2011
Key facts
- NPI
- 1497030191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28RI02885900 (NJ)
- Practice address
- 72 Crescent Ave
Waldwick, NJ 07463-1345 - Phone
- (201) 444-2754
- Fax
- (201) 497-5691
- NPI assigned
- Oct 14, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI02885900 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI02885900 | NJ | Yes |
Addresses
Primary practice location
72 Crescent Ave
Waldwick, NJ 07463-1345
Mailing address
72 Crescent Ave
Waldwick, NJ 07463-1345
Phone (201) 444-2754
Other providers in Waldwick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.