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General NPI Number Information
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NPI Number | 1215269261
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Entity Type | Individual
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Provider Name | LUCY ANNE GRAD RPH
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Gender | Female
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Dates
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Enumeration Date | 02/02/2010
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Last Update Date | 02/02/2010
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Provider Practice Location Address
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Address Line | 4777 TRANSIT RD
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City | DEPEW
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State | NY
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Zip | 14043-4772
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Country | US
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Telephone | 716-515-3290
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Fax | 716-515-3294
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Provider Business Mailing Address
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Address Line | 8187 GREINER RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-2814
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Country | US
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Telephone | 716-633-8185
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS33838
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 046572
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License Number State | NY
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