Provider Demographics
NPI:1184941122
Name:SAYERS, SUSAN VALDES (RPH)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:VALDES
Last Name:SAYERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 SLABEY AVE
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-1521
Mailing Address - Country:US
Mailing Address - Phone:516-887-2218
Mailing Address - Fax:
Practice Address - Street 1:87 SLABEY AVE
Practice Address - Street 2:
Practice Address - City:MALVERNE
Practice Address - State:NY
Practice Address - Zip Code:11565-1521
Practice Address - Country:US
Practice Address - Phone:516-887-2218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035646183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist