Provider Demographics
NPI:1649865528
Name:CANAPE, CATHERINE ANN
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:CANAPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WHISPERING PINES WAY
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-9038
Mailing Address - Country:US
Mailing Address - Phone:518-744-0647
Mailing Address - Fax:
Practice Address - Street 1:2171 GULF TO BAY BLVD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3902
Practice Address - Country:US
Practice Address - Phone:727-431-5904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS62019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist