Provider Demographics
NPI:1528359478
Name:CHESTER, ELIOT MARC (RPH)
Entity Type:Individual
Prefix:MR
First Name:ELIOT
Middle Name:MARC
Last Name:CHESTER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 STONE AVE
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-3716
Mailing Address - Country:US
Mailing Address - Phone:914-235-3232
Mailing Address - Fax:914-235-4900
Practice Address - Street 1:21 QUAKER RIDGE RD
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-2807
Practice Address - Country:US
Practice Address - Phone:914-235-3232
Practice Address - Fax:914-235-4900
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33232183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist