Provider Demographics
NPI:1801119060
Name:STRACKBEIN, TRIPURI (PHARM D)
Entity type:Individual
Prefix:MS
First Name:TRIPURI
Middle Name:
Last Name:STRACKBEIN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-5146
Mailing Address - Country:US
Mailing Address - Phone:845-338-0197
Mailing Address - Fax:845-338-0979
Practice Address - Street 1:316 BROADWAY
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-5146
Practice Address - Country:US
Practice Address - Phone:845-338-0197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist