Provider Demographics
NPI:1649584343
Name:AMY, SEAN P (RPH)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:P
Last Name:AMY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 TITUS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-3501
Mailing Address - Country:US
Mailing Address - Phone:585-544-2900
Mailing Address - Fax:585-266-8378
Practice Address - Street 1:525 TITUS AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-3501
Practice Address - Country:US
Practice Address - Phone:585-544-2900
Practice Address - Fax:585-266-8378
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054772183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist