Healthcare Provider Details

I. General information

NPI: 1447439823
Provider Name (Legal Business Name): TODD EDWARD MARTINO PHARMD./RPH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 NIAGARA ST
TONAWANDA NY
14150-1001
US

IV. Provider business mailing address

3854 WILDWING DR
NORTH TONAWANDA NY
14120-1384
US

V. Phone/Fax

Practice location:
  • Phone: 716-693-6400
  • Fax: 176-693-5048
Mailing address:
  • Phone: 716-807-2394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number048283
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: