Individual
COLETTE LYNN VIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
100 PARK AVE, SUITE FRONT E, NEW YORK, NY 10017
(800) 874-5881
Mailing address
100 PARK AVE, SUITE FRONT E, NEW YORK, NY 10017
(800) 874-5881
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
062865
NY
183500000X
Pharmacist
12169
SC
183500000X
Pharmacist
22405
NC
Other
Enumeration date
08/02/2013
Last updated
01/13/2021
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