Provider Demographics
NPI:1457957482
Name:BURBRIDGE, ADRIANA (RPH)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:BURBRIDGE
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 1:20 WELCHER AVE
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-5348
Mailing Address - Country:US
Mailing Address - Phone:914-737-1144
Mailing Address - Fax:
Practice Address - Street 1:20 WELCHER AVE
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-5348
Practice Address - Country:US
Practice Address - Phone:914-737-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-06
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY065899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist