Healthcare Provider Details

I. General information

NPI: 1457957482
Provider Name (Legal Business Name): ADRIANA BURBRIDGE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2020
Last Update Date: 12/06/2020
Certification Date: 12/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 WELCHER AVE
PEEKSKILL NY
10566-5348
US

IV. Provider business mailing address

20 WELCHER AVE
PEEKSKILL NY
10566-5348
US

V. Phone/Fax

Practice location:
  • Phone: 914-737-1144
  • Fax:
Mailing address:
  • Phone: 914-737-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number065899
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: