Provider Demographics
NPI:1619493947
Name:ITRO, LINDSAY M (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:M
Last Name:ITRO
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 ORION AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-5234
Mailing Address - Country:US
Mailing Address - Phone:845-325-4409
Mailing Address - Fax:
Practice Address - Street 1:614 COLUMBIA TPKE
Practice Address - Street 2:
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-1610
Practice Address - Country:US
Practice Address - Phone:518-479-4230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist