Provider Demographics
NPI:1407002025
Name:DE URIOSTE, SIOBHAN B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SIOBHAN
Middle Name:B
Last Name:DE URIOSTE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SIOBHAN
Other - Middle Name:B
Other - Last Name:FOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:196 NORTH ST
Mailing Address - Street 2:GENEVA GENERAL HOSPITAL
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-1651
Mailing Address - Country:US
Mailing Address - Phone:315-787-4522
Mailing Address - Fax:315-787-4528
Practice Address - Street 1:196 NORTH STREET
Practice Address - Street 2:GENEVA GENERAL HOSPITAL
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-1651
Practice Address - Country:US
Practice Address - Phone:315-787-4522
Practice Address - Fax:315-787-4528
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050343-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist