Provider Demographics
NPI:1558572776
Name:FAIRWEATHER, ANNE FRANCES (RPH)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:FRANCES
Last Name:FAIRWEATHER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:139 WEBSTER HILL RD
Mailing Address - Street 2:
Mailing Address - City:EAST NASSAU
Mailing Address - State:NY
Mailing Address - Zip Code:12062-2040
Mailing Address - Country:US
Mailing Address - Phone:518-794-7626
Mailing Address - Fax:518-828-2531
Practice Address - Street 1:173 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-1205
Practice Address - Country:US
Practice Address - Phone:518-828-4341
Practice Address - Fax:518-828-2531
Is Sole Proprietor?:No
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044472-01183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist