Provider Demographics
NPI:1083944433
Name:HUNTRESS, CAROLYN G (RPH)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:G
Last Name:HUNTRESS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:A
Other - Last Name:GAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:16 WENHAM LN
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-9627
Mailing Address - Country:US
Mailing Address - Phone:585-383-0861
Mailing Address - Fax:
Practice Address - Street 1:16 WENHAM LN
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-9627
Practice Address - Country:US
Practice Address - Phone:585-383-0861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040349-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist