Provider Demographics
NPI:1235684218
Name:DUELL, TAYLOR (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:DUELL
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 1:283 UPHAM RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13072-3167
Mailing Address - Country:US
Mailing Address - Phone:315-877-3692
Mailing Address - Fax:
Practice Address - Street 1:283 UPHAM RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:NY
Practice Address - Zip Code:13072-3167
Practice Address - Country:US
Practice Address - Phone:315-877-3692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061751183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist