Provider Demographics
NPI:1619287174
Name:POKER, ANETA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:ANETA
Middle Name:
Last Name:POKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:ANETA
Other - Middle Name:
Other - Last Name:SCIPNIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:35A WEIS RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1941
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:673 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043-3809
Practice Address - Country:US
Practice Address - Phone:518-234-4096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054884183500000X
FLPS46362183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist