Provider Demographics
NPI:1255663738
Name:KAYTON, ELLEN BRODY (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:BRODY
Last Name:KAYTON
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 SPRUCEWOOD TER
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3937
Mailing Address - Country:US
Mailing Address - Phone:716-631-0719
Mailing Address - Fax:
Practice Address - Street 1:355 SPRUCEWOOD TER
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3937
Practice Address - Country:US
Practice Address - Phone:716-631-0719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027384183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist