Provider Demographics
NPI:1235809641
Name:GENDRON, ABIGAIL PATRICE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:PATRICE
Last Name:GENDRON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13205-2555
Mailing Address - Country:US
Mailing Address - Phone:315-492-0248
Mailing Address - Fax:
Practice Address - Street 1:6040 TARBELL RD STE 103
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13206-1348
Practice Address - Country:US
Practice Address - Phone:888-843-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067990183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist