Provider Demographics
NPI:1013680891
Name:ROKJER, NATHAN (PHARMD)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:ROKJER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:NATHAN
Other - Middle Name:
Other - Last Name:ROKJER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:416 ROUTE 9W
Mailing Address - Street 2:
Mailing Address - City:GLENMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12077-3327
Mailing Address - Country:US
Mailing Address - Phone:518-462-5507
Mailing Address - Fax:
Practice Address - Street 1:416 ROUTE 9W
Practice Address - Street 2:
Practice Address - City:GLENMONT
Practice Address - State:NY
Practice Address - Zip Code:12077-3327
Practice Address - Country:US
Practice Address - Phone:518-462-5507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI066420-01183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist