Provider Demographics
NPI:1043533094
Name:NAGASA, GETU B (RPH)
Entity Type:Individual
Prefix:MR
First Name:GETU
Middle Name:B
Last Name:NAGASA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-2231
Mailing Address - Country:US
Mailing Address - Phone:716-282-3522
Mailing Address - Fax:716-282-4092
Practice Address - Street 1:1717 PINE AVE
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-2231
Practice Address - Country:US
Practice Address - Phone:716-282-3522
Practice Address - Fax:716-282-4092
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000101-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist