Provider Demographics
NPI:1902205974
Name:RUSH, STEVEN DONALD (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DONALD
Last Name:RUSH
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 1:2329 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206-3070
Mailing Address - Country:US
Mailing Address - Phone:315-437-0893
Mailing Address - Fax:315-438-3129
Practice Address - Street 1:2329 JAMES ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13206-3070
Practice Address - Country:US
Practice Address - Phone:315-437-0893
Practice Address - Fax:315-438-3129
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061696183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist