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Individual

BERNARD GUY ETTINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
756 UPPER GLEN ST, QUEENSBURY, NY 12804-2029
(518) 793-3132
Mailing address
756 UPPER GLEN ST, QUEENSBURY, NY 12804-2029
(518) 793-3132

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
028068
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00361371
NY
Enumeration date
11/16/2007
Last updated
11/16/2007
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