Healthcare Provider Details

I. General information

NPI: 1912964198
Provider Name (Legal Business Name): CRAIG J. BROZEK R.PH., D.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2006
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 TREMONT ST.
N. TONAWANDA NY
14120
US

IV. Provider business mailing address

445 TREMONT ST.
NORTH TONAWANDA NY
14120
US

V. Phone/Fax

Practice location:
  • Phone: 716-690-2233
  • Fax: 716-690-2582
Mailing address:
  • Phone: 716-690-2233
  • Fax: 716-690-2582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number027669
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: