Provider Demographics
NPI:1982410791
Name:MARCHEWKA, ALYSSA MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARIE
Last Name:MARCHEWKA
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 1:23 NEW NETHERLAND WAY
Mailing Address - Street 2:
Mailing Address - City:HALFMOON
Mailing Address - State:NY
Mailing Address - Zip Code:12065-2657
Mailing Address - Country:US
Mailing Address - Phone:518-858-0477
Mailing Address - Fax:
Practice Address - Street 1:23 NEW NETHERLAND WAY
Practice Address - Street 2:
Practice Address - City:HALFMOON
Practice Address - State:NY
Practice Address - Zip Code:12065-2657
Practice Address - Country:US
Practice Address - Phone:518-858-0477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist