Provider Demographics
NPI:1679859128
Name:CLOUTIER, ANNMARIE SLAGLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANNMARIE
Middle Name:SLAGLE
Last Name:CLOUTIER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 RONALD REAGAN BLVD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-4118
Mailing Address - Country:US
Mailing Address - Phone:845-988-5805
Mailing Address - Fax:845-988-5872
Practice Address - Street 1:44 RONALD REAGAN BLVD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-4118
Practice Address - Country:US
Practice Address - Phone:845-988-5805
Practice Address - Fax:845-988-5872
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist