Provider Demographics
NPI:1659704666
Name:ROSSI, ANGELA ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ELIZABETH
Last Name:ROSSI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 GRANT BLVD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13208-3022
Mailing Address - Country:US
Mailing Address - Phone:315-422-1851
Mailing Address - Fax:
Practice Address - Street 1:1900 GRANT BLVD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13208-3022
Practice Address - Country:US
Practice Address - Phone:315-422-1851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist