Healthcare Provider Details

I. General information

NPI: 1629379086
Provider Name (Legal Business Name): WILLIAM LOEFFLER PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2010
Last Update Date: 11/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1083 DELAWARE AVE
BUFFALO NY
14209-1635
US

IV. Provider business mailing address

5623 ANGELA DR
LOCKPORT NY
14094-6674
US

V. Phone/Fax

Practice location:
  • Phone: 716-222-0392
  • Fax:
Mailing address:
  • Phone: 860-853-8045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number052896
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: