Healthcare Provider Details

I. General information

NPI: 1609058122
Provider Name (Legal Business Name): TESS AMANDA BONE PHARM. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 01/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 ALTAMONT AVE
SCHENECTADY NY
12303-2918
US

IV. Provider business mailing address

1320 ALTAMONT AVE
SCHENECTADY NY
12303-2918
US

V. Phone/Fax

Practice location:
  • Phone: 518-355-2797
  • Fax: 518-630-4283
Mailing address:
  • Phone: 518-355-2797
  • Fax: 518-630-4283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051761
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: