Provider Demographics
NPI:1962488197
Name:BREWER, JEFFREY MICHAEL (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:BREWER
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 NEW SCOTLAND AVE
Mailing Address - Street 2:ALBANY COLLEGE OF PHARMACY AND HEALTH SCIENCES
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:106 NEW SCOTLAND AVE
Practice Address - Street 2:ALBANY COLLEGE OF PHARMACY AND HEALTH SCIENCES
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3425
Practice Address - Country:US
Practice Address - Phone:518-694-7282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD158481835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL051286841OtherPHARMACY LICENSURE
MD15848OtherPHARMACY LICENSE