Provider Demographics
NPI:1639698152
Name:RANALLO, DANA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:RANALLO
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 1:115 DANEBROCK DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3431
Mailing Address - Country:US
Mailing Address - Phone:716-984-9227
Mailing Address - Fax:
Practice Address - Street 1:1231 FRENCH RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4808
Practice Address - Country:US
Practice Address - Phone:716-668-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI063008183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist