Provider Demographics
NPI:1881891851
Name:SLISH, JUDIANNE C (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JUDIANNE
Middle Name:C
Last Name:SLISH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1193 SEVERN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-9144
Mailing Address - Country:US
Mailing Address - Phone:585-415-7258
Mailing Address - Fax:
Practice Address - Street 1:900 HOLT RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-9102
Practice Address - Country:US
Practice Address - Phone:585-872-1711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0468841835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy