Provider Demographics
NPI:1134540214
Name:HENRY, CAROLINE (RPH)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:
Last Name:HENRY
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 1:29 ASCOT RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-1403
Mailing Address - Country:US
Mailing Address - Phone:914-500-7382
Mailing Address - Fax:
Practice Address - Street 1:102 PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-2934
Practice Address - Country:US
Practice Address - Phone:914-375-9222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35065183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist