Provider Demographics
NPI:1427408517
Name:BORTON, ANGELA RENEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:RENEE
Last Name:BORTON
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 1:462 GRIDER ST
Mailing Address - Street 2:DEPARTMENT OF PHARMACY
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-3021
Mailing Address - Country:US
Mailing Address - Phone:716-898-5168
Mailing Address - Fax:716-898-4666
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:DEPARTMENT OF PHARMACY
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3021
Practice Address - Country:US
Practice Address - Phone:716-898-5168
Practice Address - Fax:716-898-4666
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0586471835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy