Provider Demographics
NPI:1356486112
Name:FELTER, ANDREW LORIN (RPH)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:LORIN
Last Name:FELTER
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 1:4978 CORNISH HEIGHTS PKWY
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215-2300
Mailing Address - Country:US
Mailing Address - Phone:315-492-4863
Mailing Address - Fax:
Practice Address - Street 1:4978 CORNISH HEIGHTS PKWY
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215-2300
Practice Address - Country:US
Practice Address - Phone:315-492-4863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040677183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist