Provider Demographics
NPI:1982870812
Name:WALKER, CELIA M (PHARMACIST)
Entity Type:Individual
Prefix:MS
First Name:CELIA
Middle Name:M
Last Name:WALKER
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 BREWSTER ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTN STA
Mailing Address - State:NY
Mailing Address - Zip Code:11746-2539
Mailing Address - Country:US
Mailing Address - Phone:631-673-9541
Mailing Address - Fax:
Practice Address - Street 1:1960 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-3327
Practice Address - Country:US
Practice Address - Phone:631-242-0951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY038926OtherPHARMACIST