Healthcare Provider Details

I. General information

NPI: 1992294896
Provider Name (Legal Business Name): ERICH DIEHL PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2018
Last Update Date: 05/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 ORCHARD PARK RD
WEST SENECA NY
14224-2634
US

IV. Provider business mailing address

905 DELAWARE AVE APT 2
BUFFALO NY
14209-2034
US

V. Phone/Fax

Practice location:
  • Phone: 716-517-3003
  • Fax:
Mailing address:
  • Phone: 215-990-1733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number062832
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: