Provider Demographics
NPI:1902677644
Name:PALLADINO, CARL ROCCO (PHARMD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:ROCCO
Last Name:PALLADINO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 BLENHEIM AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4525
Mailing Address - Country:US
Mailing Address - Phone:631-327-8005
Mailing Address - Fax:
Practice Address - Street 1:2012 S UNION AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4951
Practice Address - Country:US
Practice Address - Phone:330-829-3782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03442845183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist