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Individual
DR. NATHANIEL JAMES WADE
Active
Individual
DR. NATHANIEL JAMES WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
054637
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20 054637
STATE LICENSE
NY
Enumeration date
07/13/2010
Last updated
07/13/2010
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