Provider Demographics
NPI:1134259930
Name:GATES, GERALDINE KAY (RPH)
Entity type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:KAY
Last Name:GATES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 NOYES ST
Mailing Address - Street 2:PHARMACY
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502
Mailing Address - Country:US
Mailing Address - Phone:315-738-4072
Mailing Address - Fax:315-738-4022
Practice Address - Street 1:1400 NOYES ST
Practice Address - Street 2:PHARMACY
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502
Practice Address - Country:US
Practice Address - Phone:315-738-4072
Practice Address - Fax:315-738-4022
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33596183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist