Healthcare Provider Details

I. General information

NPI: 1841470184
Provider Name (Legal Business Name): PAMELA A. CIMINO R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2007
Last Update Date: 11/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 WILLIAM ST
BUFFALO NY
14206-2526
US

IV. Provider business mailing address

2315 WILLIAM ST
BUFFALO NY
14206-2526
US

V. Phone/Fax

Practice location:
  • Phone: 716-895-3232
  • Fax: 716-895-5405
Mailing address:
  • Phone: 716-895-3232
  • Fax: 716-895-5405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number042969
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: