Provider Demographics
NPI:1679993158
Name:LURYE, PATRICIA (RPH)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:LURYE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1038
Mailing Address - Country:US
Mailing Address - Phone:845-987-7823
Mailing Address - Fax:
Practice Address - Street 1:32 WOODSIDE DR
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-1038
Practice Address - Country:US
Practice Address - Phone:845-987-7823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY388341OtherNABP