Provider Demographics
NPI:1851758999
Name:OVERBY, AMANDA LEIGH (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEIGH
Last Name:OVERBY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 ROBINSON ST
Mailing Address - Street 2:GARVIN BUILDING
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13904-1735
Mailing Address - Country:US
Mailing Address - Phone:607-772-9100
Mailing Address - Fax:607-772-3081
Practice Address - Street 1:425 ROBINSON ST
Practice Address - Street 2:GARVIN BUILDING
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13904-1735
Practice Address - Country:US
Practice Address - Phone:607-772-9100
Practice Address - Fax:607-772-3081
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26025095A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist