Provider Demographics
NPI:1093925638
Name:PATNELLA, VICTOR JOSEPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:JOSEPH
Last Name:PATNELLA
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 1:90 RANDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1337
Mailing Address - Country:US
Mailing Address - Phone:716-689-8412
Mailing Address - Fax:
Practice Address - Street 1:1575 NIAGARA FALLS BLVD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2704
Practice Address - Country:US
Practice Address - Phone:716-831-8662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist