Individual
CARLY JO DIAMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH, PHARMD
Contact information
Practice address
726 E MAIN ST, COBLESKILL, NY 12043-3803
(518) 234-8150
Mailing address
726 EAST MAIN ST, CVS HEALTH, COBLESKILL, NY 12043
(518) 234-8150
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
069182-I
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069182-I
NYS PHARMACIST LICENSE
NY
Enumeration date
10/14/2022
Last updated
10/14/2022
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