Provider Demographics
NPI:1770808297
Name:SEARS, JEFFREY (RPH)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:SEARS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4765 COMMERCIAL DR
Mailing Address - Street 2:CONSUMER SQUARE - WALMART PHARMACY
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-6211
Mailing Address - Country:US
Mailing Address - Phone:315-738-0759
Mailing Address - Fax:
Practice Address - Street 1:4765 COMMERCIAL DR
Practice Address - Street 2:CONSUMER SQUARE - WALMART PHARMACY
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-6211
Practice Address - Country:US
Practice Address - Phone:315-736-6822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038919183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY038919OtherNYSED PHARMACIST LICENSE NUMBER