Provider Demographics
NPI:1952703829
Name:COTTOM, ELISABETH (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:
Last Name:COTTOM
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:ELISABETH
Other - Middle Name:
Other - Last Name:SCHULTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2233 STATE ROUTE 86
Mailing Address - Street 2:
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983-5644
Mailing Address - Country:US
Mailing Address - Phone:518-354-0429
Mailing Address - Fax:518-897-2605
Practice Address - Street 1:2233 STATE ROUTE 86
Practice Address - Street 2:
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-5644
Practice Address - Country:US
Practice Address - Phone:185-354-0429
Practice Address - Fax:518-897-2605
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-22
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0586641835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care