Healthcare Provider Details

I. General information

NPI: 1295953883
Provider Name (Legal Business Name): LAURA J BOSTWICK PHARM D, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA BOSTWICK PHARM D, RPH

II. Dates (important events)

Enumeration Date: 04/22/2007
Last Update Date: 09/02/2025
Certification Date:
Deactivation Date: 10/23/2009
Reactivation Date: 08/27/2025

III. Provider practice location address

315 S. MANNING BLVD INPATIENT PHARMACY ROOM 0621A
ALBANY NY
12208
US

IV. Provider business mailing address

60 WAKEFIELD CT
DELMAR NY
12054
US

V. Phone/Fax

Practice location:
  • Phone: 518-525-8992
  • Fax:
Mailing address:
  • Phone: 617-477-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21085
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number21085
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number067558
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: