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NPI Code Detail

MEDICARE: DIANA SUITOR

MEDICARE:   DIANA  SUITOR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist051807NY

General Provider Information

NPI Number : 1447572201
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA SUITOR
Provider Business Mailing Address
First Line : 1066 PAYNE AVE
Second Line :
City : NORTH TONAWANDA
State : NY
Zip : 14120-2720
Country : US
Telephone Number : 716-694-0323
Fax Number : 716-693-1506
Provider Business Practice Location Address
First Line : 1066 PAYNE AVE
Second Line :
City : NORTH TONAWANDA
State : NY
Zip : 14120-2720
Country : US
Telephone Number : 716-694-0323
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2010
Last Update Date : 12/26/2017

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Directions to “ DIANA SUITOR ” Practice Location

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