Individual
MS. ANN M VAN DE WAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1256 ALBANY ST, UTICA, NY 13501-4252
(315) 735-1400
Mailing address
1256 ALBANY ST, UTICA, NY 13501-4252
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20054531
NY
Other
Enumeration date
06/21/2010
Last updated
06/21/2010
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