Healthcare Provider Details

I. General information

NPI: 1962488197
Provider Name (Legal Business Name): JEFFREY MICHAEL BREWER PHARM.D., BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 09/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 NEW SCOTLAND AVE ALBANY COLLEGE OF PHARMACY AND HEALTH SCIENCES
ALBANY NY
12208-3425
US

IV. Provider business mailing address

106 NEW SCOTLAND AVE ALBANY COLLEGE OF PHARMACY AND HEALTH SCIENCES
ALBANY NY
12208-3425
US

V. Phone/Fax

Practice location:
  • Phone: 518-694-7282
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number15848
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: