Provider Demographics
NPI:1508198896
Name:CLYMO, AMBER MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:MARIE
Last Name:CLYMO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 WELLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-1602
Mailing Address - Country:US
Mailing Address - Phone:631-225-2528
Mailing Address - Fax:631-225-3413
Practice Address - Street 1:701 WELLWOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-1602
Practice Address - Country:US
Practice Address - Phone:631-225-2528
Practice Address - Fax:631-225-3413
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052257183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist