MEDICARE: DR. MARY J HEJNA PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	066946	NY

General Provider Information

NPI Number	:	1629674288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY J HEJNA PHARMD

Provider Business Mailing Address
First Line	:	906 WOODSTOCK AVE
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14150-5540
Country	:	US
Telephone Number	:	716-603-3130
Fax Number	:	716-568-3115

Provider Business Practice Location Address
First Line	:	1540 MAPLE RD
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14221-3647
Country	:	US
Telephone Number	:	716-568-3850
Fax Number	:	716-568-3115

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2020
Last Update Date	:	12/09/2020

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