Provider Demographics
NPI:1861674020
Name:VANVRANKEN, SUSAN M (RPH)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:VANVRANKEN
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 1:10 FOERY DR APT 104
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-6243
Mailing Address - Country:US
Mailing Address - Phone:315-525-6001
Mailing Address - Fax:
Practice Address - Street 1:8052 ROUTE 12
Practice Address - Street 2:
Practice Address - City:BARNEVELD
Practice Address - State:NY
Practice Address - Zip Code:13304
Practice Address - Country:US
Practice Address - Phone:315-896-4601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist