=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972735199
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUZANNE LESLIE STRONG R.PH.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2009
-----------------------------------------------------
Last Update Date | 08/26/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5 N TRANSIT ST
-----------------------------------------------------
City | LOCKPORT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14094-3601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-433-0367
-----------------------------------------------------
Fax | 716-433-2559
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5 N TRANSIT ST
-----------------------------------------------------
City | LOCKPORT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14094-3601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-433-0367
-----------------------------------------------------
Fax | 716-433-2559
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 044810
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 8404
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------