Provider Demographics
NPI:1225150329
Name:DEGIULIO, JAMES J (BS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:DEGIULIO
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4680 PERRY CT
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:NY
Mailing Address - Zip Code:14092-1196
Mailing Address - Country:US
Mailing Address - Phone:716-754-2470
Mailing Address - Fax:
Practice Address - Street 1:3636 RANSOMVILLE ROAD
Practice Address - Street 2:
Practice Address - City:RANSOMVILLE
Practice Address - State:NY
Practice Address - Zip Code:14131
Practice Address - Country:US
Practice Address - Phone:716-791-3038
Practice Address - Fax:716-791-4997
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34699183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist