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General NPI Number Information
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NPI Number | 1962734566
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Entity Type | Individual
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Provider Name | JENNIFER ANN PRUETZ PHARM D
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Gender | Female
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Dates
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Enumeration Date | 02/06/2010
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Last Update Date | 02/06/2010
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Provider Practice Location Address
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Address Line | 3865 UNION RD
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City | CHEEKTOWAGA
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State | NY
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Zip | 14225-4211
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Country | US
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Telephone | 716-684-5961
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Fax | 716-681-1240
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Provider Business Mailing Address
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Address Line | 186 THREE ROD RD
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City | ALDEN
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State | NY
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Zip | 14004-8835
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Country | US
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Telephone | 716-937-4993
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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 | 048151-1
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License Number State | NY
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