Provider Demographics
NPI:1225461239
Name:ACKER, ANDREA NICOLE (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:NICOLE
Last Name:ACKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4328 S BUFFALO ST
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2638
Mailing Address - Country:US
Mailing Address - Phone:716-662-3800
Mailing Address - Fax:716-662-3676
Practice Address - Street 1:4328 S BUFFALO ST
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2638
Practice Address - Country:US
Practice Address - Phone:716-662-3800
Practice Address - Fax:716-662-3676
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058392183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist