Provider Demographics
NPI:1013383611
Name:MEYER, CHARLENE ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:ELIZABETH
Last Name:MEYER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 BLUEJAY LN
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-1997
Mailing Address - Country:US
Mailing Address - Phone:716-807-7334
Mailing Address - Fax:
Practice Address - Street 1:1979 SENECA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14210-2352
Practice Address - Country:US
Practice Address - Phone:716-827-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060998183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist