Provider Demographics
NPI:1609151034
Name:WUDYKA, KRISTEN DANIELLE (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:KRISTEN
Middle Name:DANIELLE
Last Name:WUDYKA
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 1:296 WALTON DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4835
Mailing Address - Country:US
Mailing Address - Phone:716-310-9013
Mailing Address - Fax:
Practice Address - Street 1:1010 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1102
Practice Address - Country:US
Practice Address - Phone:716-541-1994
Practice Address - Fax:716-541-1996
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY55126183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist