Provider Demographics
NPI:1669795050
Name:ISGAR, LINDA DAWN (RPH)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:DAWN
Last Name:ISGAR
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 1:4116 BISHOP HILL RD
Mailing Address - Street 2:
Mailing Address - City:MARCELLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13108-9613
Mailing Address - Country:US
Mailing Address - Phone:315-673-2107
Mailing Address - Fax:315-258-9708
Practice Address - Street 1:301 GENESEE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3230
Practice Address - Country:US
Practice Address - Phone:315-258-9702
Practice Address - Fax:315-258-9708
Is Sole Proprietor?:No
Enumeration Date:2010-03-12
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI033207-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist