=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063530517
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GARY T SENF RPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 COBBLESTONE COURT DR
-----------------------------------------------------
City | VICTOR
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14564-1044
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-223-8870
-----------------------------------------------------
Fax | 585-223-9617
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 COBBLESTONE COURT DRIVE
-----------------------------------------------------
City | VICTOR
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14564-1050
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-223-8870
-----------------------------------------------------
Fax | 585-223-9617
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 029332
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------