Provider Demographics
NPI:1922615640
Name:GERKEN, MEGAN ASHLEY (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ASHLEY
Last Name:GERKEN
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 PARK AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:MECHANICVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12118-2032
Mailing Address - Country:US
Mailing Address - Phone:716-783-4754
Mailing Address - Fax:
Practice Address - Street 1:121 OLD ROUTE 146
Practice Address - Street 2:
Practice Address - City:HALFMOON
Practice Address - State:NY
Practice Address - Zip Code:12065-2912
Practice Address - Country:US
Practice Address - Phone:518-371-5842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-27
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY065732183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist