Provider Demographics
NPI:1326228651
Name:AUSTIN, ALFRED ARTHUR JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:ARTHUR
Last Name:AUSTIN
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5631 STATE HIGHWAY 12
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-3205
Mailing Address - Country:US
Mailing Address - Phone:607-336-2588
Mailing Address - Fax:607-336-2396
Practice Address - Street 1:5631 STATE HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-3205
Practice Address - Country:US
Practice Address - Phone:607-336-2588
Practice Address - Fax:607-336-2396
Is Sole Proprietor?:No
Enumeration Date:2007-11-03
Last Update Date:2007-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045440183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist