Provider Demographics
NPI:1306168307
Name:SZELES, CHRISTINE ZUMPANO (RPH)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ZUMPANO
Last Name:SZELES
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 1:21 SANGER AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-2632
Mailing Address - Country:US
Mailing Address - Phone:315-733-0124
Mailing Address - Fax:
Practice Address - Street 1:21 SANGER AVE
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-2632
Practice Address - Country:US
Practice Address - Phone:315-733-0124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist