Provider Demographics
NPI:1679896849
Name:CHASE, BRADLEY E (RPH)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:E
Last Name:CHASE
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 1:700 ELMRIDGE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-3465
Mailing Address - Country:US
Mailing Address - Phone:585-723-3406
Mailing Address - Fax:585-723-5992
Practice Address - Street 1:700 ELMRIDGE CENTER DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-3465
Practice Address - Country:US
Practice Address - Phone:585-723-3406
Practice Address - Fax:585-723-5992
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist