Provider Demographics
NPI:1659493443
Name:MARRACINO, FRANCIS JEREMIAH (RPH)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:JEREMIAH
Last Name:MARRACINO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 BIRDSONG PKWY
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-3066
Mailing Address - Country:US
Mailing Address - Phone:716-667-1924
Mailing Address - Fax:716-677-6401
Practice Address - Street 1:550 ORCHARD PARK RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2646
Practice Address - Country:US
Practice Address - Phone:716-677-6400
Practice Address - Fax:716-677-6401
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034829183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist