Provider Demographics
NPI:1255517553
Name:RALPH, EULALIA Y (RPH)
Entity type:Individual
Prefix:MRS
First Name:EULALIA
Middle Name:Y
Last Name:RALPH
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 1:2348 ROUTE 19 N
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NY
Mailing Address - Zip Code:14569-9356
Mailing Address - Country:US
Mailing Address - Phone:585-786-0880
Mailing Address - Fax:585-786-0882
Practice Address - Street 1:2348 ROUTE 19 N
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-9356
Practice Address - Country:US
Practice Address - Phone:585-786-0880
Practice Address - Fax:585-786-0882
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038483-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist