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General NPI Number Information
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NPI Number | 1942071584
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Entity Type | Individual
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Provider Name | NIVLA IREA ATUAM PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 1431 MOUNT HOPE AVE
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City | ROCHESTER
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State | NY
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Zip | 14620-3912
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Country | US
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Telephone | 585-271-5031
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Fax |
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Provider Business Mailing Address
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Address Line | 5864 PHEBE CT
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City | FARMINGTON
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State | NY
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Zip | 14425-8830
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Country | US
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Telephone | 214-797-9773
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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 | 071006
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License Number State | NY
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