Provider Demographics
NPI:1215583448
Name:PAWLEWICZ, ALEXIS (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:PAWLEWICZ
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 JANE LACEY DR APT S
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-3743
Mailing Address - Country:US
Mailing Address - Phone:315-380-2406
Mailing Address - Fax:
Practice Address - Street 1:215 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:WALTON
Practice Address - State:NY
Practice Address - Zip Code:13856-1019
Practice Address - Country:US
Practice Address - Phone:607-865-7147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY065662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist