Provider Demographics
NPI:1255654521
Name:ADLHOCK, NANCY L (RPH)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:L
Last Name:ADLHOCK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WOLFBORO DR
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-9380
Mailing Address - Country:US
Mailing Address - Phone:585-425-0566
Mailing Address - Fax:
Practice Address - Street 1:5 WOLFBORO DR
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-9380
Practice Address - Country:US
Practice Address - Phone:585-425-0566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI1039273-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI1039273-1Medicaid