Provider Demographics
NPI:1073781191
Name:BALONE, SALVATORE JOSEPH (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:SALVATORE
Middle Name:JOSEPH
Last Name:BALONE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 BAUMAN RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2724
Mailing Address - Country:US
Mailing Address - Phone:716-688-7356
Mailing Address - Fax:
Practice Address - Street 1:142 GRANT ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-1605
Practice Address - Country:US
Practice Address - Phone:716-885-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023819-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist