Provider Demographics
NPI:1255663159
Name:AUERBACH, SIDNEY IRA (RPH)
Entity Type:Individual
Prefix:MR
First Name:SIDNEY
Middle Name:IRA
Last Name:AUERBACH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2405
Mailing Address - Country:US
Mailing Address - Phone:914-428-1621
Mailing Address - Fax:914-428-2551
Practice Address - Street 1:1 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-2405
Practice Address - Country:US
Practice Address - Phone:914-428-1621
Practice Address - Fax:914-428-2551
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025414183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist