Provider Demographics
NPI:1760685499
Name:ENOS, MAUREEN M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:M
Last Name:ENOS
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 1:24 CINDY LN
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-5660
Mailing Address - Country:US
Mailing Address - Phone:518-383-9070
Mailing Address - Fax:
Practice Address - Street 1:92 MAIN ST
Practice Address - Street 2:
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839-2216
Practice Address - Country:US
Practice Address - Phone:518-747-9184
Practice Address - Fax:518-746-0861
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist