Provider Demographics
NPI:1639354632
Name:BOECKEL, AMANDA J (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:J
Last Name:BOECKEL
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 1:311 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:EAST ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14445-1401
Mailing Address - Country:US
Mailing Address - Phone:908-241-6337
Mailing Address - Fax:585-394-9220
Practice Address - Street 1:539 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1033
Practice Address - Country:US
Practice Address - Phone:585-394-7930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051820183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist