Healthcare Provider Details

I. General information

NPI: 1639299613
Provider Name (Legal Business Name): LYNN MARIE DALY BS PHARMACY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3713 S PARK AVE
BLASDELL NY
14219-1129
US

IV. Provider business mailing address

14 BRAUNVIEW WAY
ORCHARD PARK NY
14127-2046
US

V. Phone/Fax

Practice location:
  • Phone: 716-823-9800
  • Fax: 716-823-6433
Mailing address:
  • Phone: 716-662-2148
  • Fax: 716-823-6433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number032482
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: