Provider Demographics
NPI:1295057883
Name:ZANDRI, MICHAEL JOHN (RPH)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOHN
Last Name:ZANDRI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:342 NORTHERN LIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:N SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-4127
Mailing Address - Country:US
Mailing Address - Phone:315-455-7925
Mailing Address - Fax:315-455-5475
Practice Address - Street 1:342 NORTHERN LIGHTS DR
Practice Address - Street 2:
Practice Address - City:N SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-4127
Practice Address - Country:US
Practice Address - Phone:315-455-7925
Practice Address - Fax:315-455-5475
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist