Provider Demographics
NPI:1205602422
Name:BRAMLETT, SYDNEY LEE (PHARMD)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:LEE
Last Name:BRAMLETT
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 1:10109 ROCKAWAY ST
Mailing Address - Street 2:
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-5223
Mailing Address - Country:US
Mailing Address - Phone:813-763-1604
Mailing Address - Fax:
Practice Address - Street 1:10109 ROCKAWAY ST
Practice Address - Street 2:
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020-5223
Practice Address - Country:US
Practice Address - Phone:813-763-1604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist