Provider Demographics
NPI:1477682656
Name:BARRETT, JUDITH L (RPH)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:L
Last Name:BARRETT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:JUDITH
Other - Middle Name:L
Other - Last Name:MAROIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:117 3RD ST
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-3745
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:99 WASHINGTON AVE
Practice Address - Street 2:STE 720
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12210-2822
Practice Address - Country:US
Practice Address - Phone:518-486-3209
Practice Address - Fax:518-473-5508
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037458183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist