Provider Demographics
NPI:1609058122
Name:BONE, TESS AMANDA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:TESS
Middle Name:AMANDA
Last Name:BONE
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 1:1320 ALTAMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-2918
Mailing Address - Country:US
Mailing Address - Phone:518-355-2797
Mailing Address - Fax:518-630-4283
Practice Address - Street 1:1320 ALTAMONT AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-2918
Practice Address - Country:US
Practice Address - Phone:518-355-2797
Practice Address - Fax:518-630-4283
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2009-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051761183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist