Provider Demographics
NPI:1952128712
Name:EKERT, AMELIA ANNE
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:ANNE
Last Name:EKERT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10A BELLEARD LN
Mailing Address - Street 2:
Mailing Address - City:HALFMOON
Mailing Address - State:NY
Mailing Address - Zip Code:12065-7820
Mailing Address - Country:US
Mailing Address - Phone:908-477-8822
Mailing Address - Fax:
Practice Address - Street 1:724 GLEN ST
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-2019
Practice Address - Country:US
Practice Address - Phone:518-793-3132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist