Provider Demographics
NPI:1649579442
Name:ACHARYA, GEETA
Entity Type:Individual
Prefix:
First Name:GEETA
Middle Name:
Last Name:ACHARYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 BARRETT DRIVE
Mailing Address - Street 2:A&J PHARMACY
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2963
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:60 BARRETT DRIVE
Practice Address - Street 2:A&J PHARMACY
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2963
Practice Address - Country:US
Practice Address - Phone:585-872-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0737672-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist