Healthcare Provider Details

I. General information

NPI: 1639411242
Provider Name (Legal Business Name): SARAH E GORAL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2013
Last Update Date: 03/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6344 TRANSIT RD
DEPEW NY
14043-1031
US

IV. Provider business mailing address

6344 TRANSIT RD
DEPEW NY
14043-1031
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 Number048480-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: