Provider Demographics
NPI:1992863930
Name:O'DOWD, MICHAEL WILLIAM JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:O'DOWD
Suffix:JR
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 1:21 SANDYFIELDS LANE
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-3515
Mailing Address - Country:US
Mailing Address - Phone:845-429-1998
Mailing Address - Fax:845-290-0539
Practice Address - Street 1:21 SANDYFIELDS LN
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-3515
Practice Address - Country:US
Practice Address - Phone:845-429-1998
Practice Address - Fax:845-290-0539
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035653183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist