Healthcare Provider Details

I. General information

NPI: 1780347567
Provider Name (Legal Business Name): NALEINE CAMILLE NEEBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 11/13/2021
Certification Date: 11/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 MAIN ST
HIGHLAND FALLS NY
10928-2103
US

IV. Provider business mailing address

1 FITZGERALD DR
MIDDLETOWN NY
10940-3059
US

V. Phone/Fax

Practice location:
  • Phone: 845-446-3170
  • Fax:
Mailing address:
  • Phone: 845-343-2930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number068440
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: