Provider Demographics
NPI:1568610160
Name:CRABTREE, AMANDA L (PHARM D)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:CRABTREE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8379 THOMPSON RD
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:NY
Mailing Address - Zip Code:13039-9390
Mailing Address - Country:US
Mailing Address - Phone:315-699-9608
Mailing Address - Fax:315-699-1571
Practice Address - Street 1:8379 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039-9390
Practice Address - Country:US
Practice Address - Phone:315-699-9608
Practice Address - Fax:315-699-1571
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist