Provider Demographics
NPI:1821711185
Name:MARQUEZ, ANGEL H (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:H
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 AVERY ST
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NY
Mailing Address - Zip Code:13838-1202
Mailing Address - Country:US
Mailing Address - Phone:607-624-8032
Mailing Address - Fax:
Practice Address - Street 1:14 AVERY ST
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NY
Practice Address - Zip Code:13838-1202
Practice Address - Country:US
Practice Address - Phone:607-624-8032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069679183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY069679OtherNYSED