Provider Demographics
NPI:1760587794
Name:DUTCH, JANIE W (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JANIE
Middle Name:W
Last Name:DUTCH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4881 CLARK LN
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-1533
Mailing Address - Country:US
Mailing Address - Phone:315-425-4400
Mailing Address - Fax:315-425-2489
Practice Address - Street 1:800 IRVING AVE
Practice Address - Street 2:ATTENTION: PHARMACY MC119
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2716
Practice Address - Country:US
Practice Address - Phone:315-425-4400
Practice Address - Fax:315-425-2489
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042036L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist