Healthcare Provider Details

I. General information

NPI: 1023860251
Provider Name (Legal Business Name): CIERRA MELONE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6344 TRANSIT RD
DEPEW NY
14043-1031
US

IV. Provider business mailing address

770 W FERRY ST APT 27A
BUFFALO NY
14222-2401
US

V. Phone/Fax

Practice location:
  • Phone: 716-683-9444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI-070861
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: