Provider Demographics
NPI:1760609648
Name:DADDARIO, ARTHUR A (RPH)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:A
Last Name:DADDARIO
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 1:2476 SWIFT RD
Mailing Address - Street 2:
Mailing Address - City:LA FAYETTE
Mailing Address - State:NY
Mailing Address - Zip Code:13084-9576
Mailing Address - Country:US
Mailing Address - Phone:315-677-9650
Mailing Address - Fax:
Practice Address - Street 1:300 GIFFORD ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-3257
Practice Address - Country:US
Practice Address - Phone:315-471-4139
Practice Address - Fax:315-471-4155
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist