Provider Demographics
NPI:1184005449
Name:COPPERWHEAT, AUBREY M (PHARMD)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:M
Last Name:COPPERWHEAT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CASEY CT
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3819
Mailing Address - Country:US
Mailing Address - Phone:315-266-7916
Mailing Address - Fax:
Practice Address - Street 1:560 N GREENBUSH RD
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-9452
Practice Address - Country:US
Practice Address - Phone:518-283-6982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20 058403183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist