Individual
MISS MACKENZIE MAE MCGRAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
177 ERIE BLVD, SUSQUEHANNA, PA 18847-2791
(570) 853-0901
Mailing address
46 MURPHY LN, NEWARK VALLEY, NY 13811-4752
(607) 778-9557
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
30032403
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30032403
PHARMACY TECHNICIAN CERTIFICATION BOARD
—
Enumeration date
05/06/2020
Last updated
05/06/2020
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