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General NPI Number Information
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NPI Number | 1417167099
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Entity Type | Individual
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Provider Name | MARY LOU PATNELLA
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1770 COLVIN BLVD
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City | BUFFALO
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State | NY
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Zip | 14223-1108
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Country | US
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Telephone | 716-876-2323
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Fax |
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Provider Business Mailing Address
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Address Line | 90 RANDWOOD DR
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City | GETZVILLE
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State | NY
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Zip | 14068-1337
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Country | US
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Telephone | 716-689-8412
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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 | 035969
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License Number State | NY
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