Healthcare Provider Details

I. General information

NPI: 1356663470
Provider Name (Legal Business Name): MAURA WYCHOWSKI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2010
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1142 WEHRLE DR
BUFFALO NY
14221-7750
US

IV. Provider business mailing address

7 PICCADILLY SQ
ROCHESTER NY
14625-1367
US

V. Phone/Fax

Practice location:
  • Phone: 716-633-3900
  • Fax:
Mailing address:
  • Phone: 914-715-1469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number051211
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: