Provider Demographics
NPI:1083937932
Name:PEZZINO, SHARON L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:L
Last Name:PEZZINO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8290 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2820
Mailing Address - Country:US
Mailing Address - Phone:716-639-8204
Mailing Address - Fax:716-639-8204
Practice Address - Street 1:8290 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-2820
Practice Address - Country:US
Practice Address - Phone:716-639-8204
Practice Address - Fax:716-639-8204
Is Sole Proprietor?:No
Enumeration Date:2010-03-07
Last Update Date:2010-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038915183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist