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General NPI Number Information
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NPI Number | 1477914257
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Entity Type | Individual
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Provider Name | GREGORY M BLETTE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 03/08/2016
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 144 GENESEE ST 5TH FLOOR
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City | BUFFALO
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State | NY
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Zip | 14203-1560
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Country | US
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Telephone | 716-359-8306
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Fax |
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Provider Business Mailing Address
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Address Line | 144 GENESEE ST 5TH FLOOR
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City | BUFFALO
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State | NY
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Zip | 14203-1560
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Country | US
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Telephone |
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 26025526A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 061390
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License Number State | NY
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