Provider Demographics
NPI:1841474582
Name:CRUVER, YVETTE SHEREE (RPH)
Entity type:Individual
Prefix:MS
First Name:YVETTE
Middle Name:SHEREE
Last Name:CRUVER
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 1:103 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-2626
Mailing Address - Country:US
Mailing Address - Phone:845-457-3023
Mailing Address - Fax:
Practice Address - Street 1:103 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-2626
Practice Address - Country:US
Practice Address - Phone:845-457-3023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038877183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist