Healthcare Provider Details

I. General information

NPI: 1053747139
Provider Name (Legal Business Name): SARAH WURZ PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 09/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 ERIE BLVD E
SYRACUSE NY
13224-1109
US

IV. Provider business mailing address

2515 ERIE BLVD E
SYRACUSE NY
13224-1109
US

V. Phone/Fax

Practice location:
  • Phone: 315-449-1016
  • Fax: 315-449-2666
Mailing address:
  • Phone: 315-449-1016
  • Fax: 315-449-2666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number056921
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: