Provider Demographics
NPI:1174700140
Name:CHAMBERLAIN, BRIAN KENNETH (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:KENNETH
Last Name:CHAMBERLAIN
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ELM RIDGE CENTER DR.
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-3459
Mailing Address - Country:US
Mailing Address - Phone:585-227-1210
Mailing Address - Fax:585-227-4808
Practice Address - Street 1:100 ELM RIDGE CENTER DR.
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-3459
Practice Address - Country:US
Practice Address - Phone:585-227-1210
Practice Address - Fax:585-227-4808
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050403183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist