Provider Demographics
NPI:1619159878
Name:SZYMKOWSKI, CHERYL A (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:A
Last Name:SZYMKOWSKI
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 1:214 SENECA PL
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-1361
Mailing Address - Country:US
Mailing Address - Phone:716-684-4084
Mailing Address - Fax:
Practice Address - Street 1:2565 UNION RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227-2205
Practice Address - Country:US
Practice Address - Phone:716-668-6024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00980098Medicaid