Provider Demographics
NPI:1245469220
Name:BARRANCA, AUGUSTINE N III (RPH)
Entity type:Individual
Prefix:MR
First Name:AUGUSTINE
Middle Name:N
Last Name:BARRANCA
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 MILLER RD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CASTLETON
Mailing Address - State:NY
Mailing Address - Zip Code:12033-4035
Mailing Address - Country:US
Mailing Address - Phone:518-512-5181
Mailing Address - Fax:518-512-5184
Practice Address - Street 1:81 MILLER RD
Practice Address - Street 2:SUITE 700
Practice Address - City:CASTLETON
Practice Address - State:NY
Practice Address - Zip Code:12033-4035
Practice Address - Country:US
Practice Address - Phone:518-512-5181
Practice Address - Fax:518-512-5184
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032936-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist