Provider Demographics
NPI:1336429794
Name:HOLZHAUER, MELISSA ANNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ANNE
Last Name:HOLZHAUER
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 1:112 NEW YORK RD
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12903-3933
Mailing Address - Country:US
Mailing Address - Phone:518-562-3380
Mailing Address - Fax:518-562-9751
Practice Address - Street 1:112 NEW YORK RD
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12903-3933
Practice Address - Country:US
Practice Address - Phone:518-562-3380
Practice Address - Fax:518-562-9751
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057990-1183500000X
OR0012994183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0012994OtherOREGON STATE PHARMACIST LICENSE NUMBER
NY057990-1OtherNEW YORK STATE PHARMACIST LICENSE NUMBER