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General NPI Number Information
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NPI Number | 1679905129
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Entity Type | Individual
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Provider Name | CHRISTINA M HICKEY RPH
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Gender | Female
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Dates
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Enumeration Date | 08/07/2013
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Last Update Date | 08/07/2013
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Provider Practice Location Address
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Address Line | 3177 LATTA RD
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City | ROCHESTER
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State | NY
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Zip | 14612-3094
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Country | US
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Telephone | 585-225-6111
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Fax | 585-723-6289
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Provider Business Mailing Address
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Address Line | 3177 LATTA RD
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City | ROCHESTER
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State | NY
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Zip | 14612-3094
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Country | US
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Telephone | 585-225-6111
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Fax | 585-723-6289
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 058236
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License Number State | NY
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