Provider Demographics
NPI:1609699313
Name:PUREWAL, SUKHMIR KAUR (RPH)
Entity type:Individual
Prefix:
First Name:SUKHMIR
Middle Name:KAUR
Last Name:PUREWAL
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 1:409 CHESTNUT HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-6113
Mailing Address - Country:US
Mailing Address - Phone:315-560-2740
Mailing Address - Fax:
Practice Address - Street 1:519 BUTTERNUT ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13208-2628
Practice Address - Country:US
Practice Address - Phone:315-471-1204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-02
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist