Provider Demographics
NPI:1609017664
Name:BROCKLEY, RACHEL MARIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:BROCKLEY
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 1:3020 ROUTE 50
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-2946
Mailing Address - Country:US
Mailing Address - Phone:518-580-8850
Mailing Address - Fax:518-580-8856
Practice Address - Street 1:3020 ROUTE 50
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2946
Practice Address - Country:US
Practice Address - Phone:518-580-8850
Practice Address - Fax:518-580-8856
Is Sole Proprietor?:No
Enumeration Date:2009-03-20
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist