Provider Demographics
NPI:1457006470
Name:RUGGIERO, ELISA MICHELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELISA
Middle Name:MICHELLE
Last Name:RUGGIERO
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 1:8045 CLARENCE CENTER RD
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1916
Mailing Address - Country:US
Mailing Address - Phone:716-341-2807
Mailing Address - Fax:
Practice Address - Street 1:125 S TRANSIT ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-4834
Practice Address - Country:US
Practice Address - Phone:716-433-2678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067660183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist