Provider Demographics
NPI:1235318494
Name:SMOLLER, NEAL ROBERT JR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NEAL
Middle Name:ROBERT
Last Name:SMOLLER
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-1311
Mailing Address - Country:US
Mailing Address - Phone:845-247-0010
Mailing Address - Fax:845-247-0064
Practice Address - Street 1:31 MARKET ST
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-1311
Practice Address - Country:US
Practice Address - Phone:845-247-0010
Practice Address - Fax:845-247-0064
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049729183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist