Provider Demographics
NPI:1669683181
Name:WELLS, DENISE M (RPH)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:WELLS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 CUMMINGS AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:NY
Mailing Address - Zip Code:14001-1057
Mailing Address - Country:US
Mailing Address - Phone:716-542-6219
Mailing Address - Fax:
Practice Address - Street 1:ROSWELL PARK CANCER INSTITUTE PHARMACY DEPT
Practice Address - Street 2:ELM & CARLTON STREETS
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-0001
Practice Address - Country:US
Practice Address - Phone:716-845-3298
Practice Address - Fax:716-845-8708
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04387411835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology