Provider Demographics
NPI:1356520944
Name:BULMER, NICOLE AIMEE (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:AIMEE
Last Name:BULMER
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 BUTTERNUT ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13208-2628
Mailing Address - Country:US
Mailing Address - Phone:315-471-1204
Mailing Address - Fax:315-471-0871
Practice Address - Street 1:519 BUTTERNUT ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13208-2628
Practice Address - Country:US
Practice Address - Phone:315-471-1204
Practice Address - Fax:315-471-0871
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist