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NPI 1801445002

NPI 1801445002 : ELIZABETH ROSE PASTOR PHARMD, RPH : CLIFTON PARK, NY

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General NPI Number Information
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    NPI Number           |    1801445002
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    Entity Type          |    Individual 
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    Provider Name        |    ELIZABETH ROSE PASTOR PHARMD, RPH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/10/2019
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    Last Update Date     |    03/21/2020
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Provider Practice Location Address
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    Address Line         |    31 BROADLEAF DR 
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    City                 |    CLIFTON PARK
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    State                |    NY
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    Zip                  |    12065-5718
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    Country              |    US
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    Telephone            |    518-813-6524
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    305 STILLWATER DR N 
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    City                 |    HORSEHEADS
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    State                |    NY
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    Zip                  |    14845-1321
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    Country              |    US
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    Telephone            |    518-813-6524
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    Fax                  |    
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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       |    065955
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    License Number State |    NY
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