Provider Demographics
NPI:1316601222
Name:MAGEE, MAGAN MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MAGAN
Middle Name:MARIE
Last Name:MAGEE
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 1:91 ENOLA AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1707
Mailing Address - Country:US
Mailing Address - Phone:518-536-2754
Mailing Address - Fax:
Practice Address - Street 1:424 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-2210
Practice Address - Country:US
Practice Address - Phone:518-536-2754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068559183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist