Healthcare Provider Details

I. General information

NPI: 1942281910
Provider Name (Legal Business Name): ANTHONY JOSEPH GRAZIANO R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 N MAIN ST
ALFRED NY
14802-1011
US

IV. Provider business mailing address

PO BOX 612
ALFRED NY
14802-0612
US

V. Phone/Fax

Practice location:
  • Phone: 607-587-9222
  • Fax: 607-587-9629
Mailing address:
  • Phone: 607-587-9222
  • Fax: 607-587-9629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number036075-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: