Provider Demographics
NPI:1700037314
Name:EMERY, PETER H JR (RPH)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:H
Last Name:EMERY
Suffix:JR
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 1:3215 POMPEY CENTER RD
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-9562
Mailing Address - Country:US
Mailing Address - Phone:315-424-7027
Mailing Address - Fax:315-424-7638
Practice Address - Street 1:3215 POMPEY CENTER ROAD
Practice Address - Street 2:
Practice Address - City:MANLIUS
Practice Address - State:NY
Practice Address - Zip Code:13104
Practice Address - Country:US
Practice Address - Phone:315-424-7027
Practice Address - Fax:315-424-7638
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038123183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist