Provider Demographics
NPI:1407034820
Name:TORREY, TRACEY LYNN (RPH)
Entity Type:Individual
Prefix:MS
First Name:TRACEY
Middle Name:LYNN
Last Name:TORREY
Suffix:
Gender:F
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:RT. 5 & OXBOW RD
Mailing Address - Street 2:
Mailing Address - City:CANASTOTA
Mailing Address - State:NY
Mailing Address - Zip Code:13032-4784
Mailing Address - Country:US
Mailing Address - Phone:315-697-2262
Mailing Address - Fax:315-697-2517
Practice Address - Street 1:RT. 5 & OXBOW RD
Practice Address - Street 2:
Practice Address - City:CANASTOTA
Practice Address - State:NY
Practice Address - Zip Code:13032-4784
Practice Address - Country:US
Practice Address - Phone:315-697-2262
Practice Address - Fax:315-697-2517
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046137183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist