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General NPI Number Information
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NPI Number | 1952524225
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Entity Type | Individual
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Provider Name | WALTER JOHN SOCHA JR. RPH
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Gender | Male
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 342 NORTHERN LIGHTS DR
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City | NORTH SYRACUSE
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State | NY
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Zip | 13212-4127
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Country | US
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Telephone | 315-455-7925
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Fax |
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Provider Business Mailing Address
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Address Line | 102 HALLMORE DR
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City | CAMILLUS
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State | NY
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Zip | 13031-2004
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Country | US
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Telephone | 315-487-3521
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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 | 027590
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License Number State | NY
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