Provider Demographics
NPI:1275855793
Name:RAHN, CONCETTA C (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CONCETTA
Middle Name:C
Last Name:RAHN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:CONCETTA
Other - Middle Name:
Other - Last Name:CARUSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:49 KELLOGG RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-2849
Mailing Address - Country:US
Mailing Address - Phone:315-734-1893
Mailing Address - Fax:315-734-1896
Practice Address - Street 1:49 KELLOGG RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-2849
Practice Address - Country:US
Practice Address - Phone:315-734-1893
Practice Address - Fax:315-734-1896
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038777-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist