Provider Demographics
NPI:1326219072
Name:SALYER, DEAN (RPH)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:
Last Name:SALYER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10560 ROUTE 19
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14735-0272
Mailing Address - Country:US
Mailing Address - Phone:585-567-2228
Mailing Address - Fax:
Practice Address - Street 1:10560 ROUTE 19
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:NY
Practice Address - Zip Code:14735-0272
Practice Address - Country:US
Practice Address - Phone:585-567-2228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036977183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01295014Medicaid