Provider Demographics
NPI:1376867630
Name:ZABLE, DAVID ROBERT (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ROBERT
Last Name:ZABLE
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 1:57 GREGORY RD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-4705
Mailing Address - Country:US
Mailing Address - Phone:845-794-0188
Mailing Address - Fax:845-794-0188
Practice Address - Street 1:57 GREGORY RD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-4705
Practice Address - Country:US
Practice Address - Phone:845-794-0188
Practice Address - Fax:845-794-0188
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY035015OtherNYS LICENSE