Provider Demographics
NPI:1225099724
Name:NOWAK, ELIZABETH HELEN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:HELEN
Last Name:NOWAK
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 1:52 GREGORY DR
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1055
Mailing Address - Country:US
Mailing Address - Phone:716-826-0387
Mailing Address - Fax:
Practice Address - Street 1:65 GREY ST
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-2126
Practice Address - Country:US
Practice Address - Phone:716-655-6381
Practice Address - Fax:716-655-6431
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044469183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist