Healthcare Provider Details

I. General information

NPI: 1033876149
Provider Name (Legal Business Name): ANUSHA SEKHAR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2021
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 RIDGE ST
GLENS FALLS NY
12801-3624
US

IV. Provider business mailing address

31 PONDEROSA DR
HALFMOON NY
12065-6209
US

V. Phone/Fax

Practice location:
  • Phone: 518-738-6066
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number67724-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: