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General NPI Number Information
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NPI Number | 1881891851
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Entity Type | Individual
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Provider Name | JUDIANNE C SLISH PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 900 HOLT RD
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City | WEBSTER
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State | NY
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Zip | 14580-9102
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Country | US
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Telephone | 585-872-1711
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Fax |
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Provider Business Mailing Address
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Address Line | 1193 SEVERN RIDGE RD
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City | WEBSTER
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State | NY
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Zip | 14580-9144
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Country | US
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Telephone | 585-415-7258
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 046884
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License Number State | NY
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