Provider Demographics
NPI:1407232424
Name:CARROLL, GIANNA ELISE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GIANNA
Middle Name:ELISE
Last Name:CARROLL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:GIANNA
Other - Middle Name:ELISE
Other - Last Name:OGNIBENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5735 S TRANSIT RD
Mailing Address - Street 2:ATTN PHARMACY
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-5864
Mailing Address - Country:US
Mailing Address - Phone:716-438-2748
Mailing Address - Fax:
Practice Address - Street 1:5735 S TRANSIT RD
Practice Address - Street 2:ATTN PHARMACY
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-5864
Practice Address - Country:US
Practice Address - Phone:716-438-2748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist