Provider Demographics
NPI:1992900443
Name:HALLADAY, AMY LOUISE (RPH)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:LOUISE
Last Name:HALLADAY
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 1:1704 STARDUST LN
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1639
Mailing Address - Country:US
Mailing Address - Phone:716-307-1783
Mailing Address - Fax:
Practice Address - Street 1:1869 PLAZA DR
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1864
Practice Address - Country:US
Practice Address - Phone:716-373-2786
Practice Address - Fax:716-373-2788
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist