Provider Demographics
NPI:1467662221
Name:BURGHOLZER, ROSEMARIE MORETUZZO (RPH)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:MORETUZZO
Last Name:BURGHOLZER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 OLNEY DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3344
Mailing Address - Country:US
Mailing Address - Phone:716-837-9218
Mailing Address - Fax:716-839-3408
Practice Address - Street 1:4968 HARLEM RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-2560
Practice Address - Country:US
Practice Address - Phone:716-837-9218
Practice Address - Fax:716-839-3408
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31521183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist