Provider Demographics
NPI:1518002419
Name:PURDY, MICHELLE MAY (RPH)
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:MAY
Last Name:PURDY
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 1:47 DICKINSON AVE
Mailing Address - Street 2:#1
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-1753
Mailing Address - Country:US
Mailing Address - Phone:607-624-6766
Mailing Address - Fax:607-770-0939
Practice Address - Street 1:343 CLINTON ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-2017
Practice Address - Country:US
Practice Address - Phone:607-729-2234
Practice Address - Fax:607-770-0939
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist