Healthcare Provider Details

I. General information

NPI: 1245411826
Provider Name (Legal Business Name): ANNE NEWMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2007
Last Update Date: 11/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 MEADOW DR
NORTH TONAWANDA NY
14120-2815
US

IV. Provider business mailing address

42 SNUG HAVEN CT
TONAWANDA NY
14150-8510
US

V. Phone/Fax

Practice location:
  • Phone: 716-694-2001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number040765
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: