Provider Demographics
NPI:1013192608
Name:DELUCA, SARAH (PHARM D, RPH)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:DELUCA
Suffix:
Gender:F
Credentials:PHARM D, RPH
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:HAGELIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D, RPH
Mailing Address - Street 1:5622 AMANDA LN
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1555
Mailing Address - Country:US
Mailing Address - Phone:716-821-9844
Mailing Address - Fax:
Practice Address - Street 1:5622 AMANDA LN
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1555
Practice Address - Country:US
Practice Address - Phone:716-821-9844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist