Provider Demographics
NPI:1144542440
Name:PRESTON, SANDRA (PHARMD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:PRESTON
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 1:415 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12209-1615
Mailing Address - Country:US
Mailing Address - Phone:518-463-2986
Mailing Address - Fax:518-463-1724
Practice Address - Street 1:415 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12209-1615
Practice Address - Country:US
Practice Address - Phone:518-463-2986
Practice Address - Fax:518-463-1724
Is Sole Proprietor?:No
Enumeration Date:2010-02-28
Last Update Date:2010-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040778-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist