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NPI Code Detail

MEDICARE: TORI GONPUTH

MEDICARE: TORI GONPUTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist072973NY

General Provider Information

NPI Number : 1801775465
Entity Type Code : Individual
Provider Name (Legal Business Name) : TORI GONPUTH
Provider Business Mailing Address
First Line : 108 NORTHAMPTON RD APT 9D
Second Line :
City : AMSTERDAM
State : NY
Zip : 12010-1718
Country : US
Telephone Number : 518-603-4489
Fax Number :
Provider Business Practice Location Address
First Line : 4999 STATE HIGHWAY 30
Second Line :
City : AMSTERDAM
State : NY
Zip : 12010-7521
Country : US
Telephone Number : 518-843-6661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2025
Last Update Date : 08/28/2025

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Directions to “ TORI GONPUTH ” Practice Location

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