Provider Demographics
NPI:1164600680
Name:PINCHER, TYSON JAMES (PHARMD)
Entity Type:Individual
Prefix:
First Name:TYSON
Middle Name:JAMES
Last Name:PINCHER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:864 KNOX CAVE ROAD
Mailing Address - Street 2:
Mailing Address - City:KNOX
Mailing Address - State:NY
Mailing Address - Zip Code:12107
Mailing Address - Country:US
Mailing Address - Phone:518-872-0114
Mailing Address - Fax:
Practice Address - Street 1:864 KNOX CAVE ROAD
Practice Address - Street 2:
Practice Address - City:KNOX
Practice Address - State:NY
Practice Address - Zip Code:12107
Practice Address - Country:US
Practice Address - Phone:518-872-0114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051728-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist