Provider Demographics
NPI:1578916235
Name:ALTIERI, DEANNA MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:MARIE
Last Name:ALTIERI
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 1:453 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-1805
Mailing Address - Country:US
Mailing Address - Phone:716-597-6071
Mailing Address - Fax:
Practice Address - Street 1:205 PARK CLUB LN
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14221-5239
Practice Address - Country:US
Practice Address - Phone:716-597-6071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061838183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist