Provider Demographics
NPI:1891317822
Name:MCENERNEY, MARY HESSLER (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:HESSLER
Last Name:MCENERNEY
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 1:804 GEORGIAN DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:NY
Mailing Address - Zip Code:14414-1470
Mailing Address - Country:US
Mailing Address - Phone:941-961-4296
Mailing Address - Fax:
Practice Address - Street 1:1400 COUNTY RD 64
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845
Practice Address - Country:US
Practice Address - Phone:607-739-1714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI066385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist