Provider Demographics
NPI:1407178163
Name:REFF, MICHELLE MARIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:MARIE
Last Name:REFF
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:MARIE
Other - Last Name:BRANCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:22586 COOK RD
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-5672
Mailing Address - Country:US
Mailing Address - Phone:315-486-7638
Mailing Address - Fax:
Practice Address - Street 1:22056 US ROUTE 11
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-1658
Practice Address - Country:US
Practice Address - Phone:315-782-6530
Practice Address - Fax:315-786-0870
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist