Healthcare Provider Details

I. General information

NPI: 1871646042
Provider Name (Legal Business Name): STEPHEN CRAIG SZCZEPANSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4328 S BUFFALO ST
ORCHARD PARK NY
14127-2638
US

IV. Provider business mailing address

3 HILLSBORO DR
ORCHARD PARK NY
14127-3412
US

V. Phone/Fax

Practice location:
  • Phone: 716-662-3800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number047835
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: