Provider Demographics
NPI:1710260641
Name:PRZESPO, EUGENE RAYMOND (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:RAYMOND
Last Name:PRZESPO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 MAY DR
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:NY
Mailing Address - Zip Code:14059-9201
Mailing Address - Country:US
Mailing Address - Phone:716-208-7335
Mailing Address - Fax:
Practice Address - Street 1:265 N UNION ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-2663
Practice Address - Country:US
Practice Address - Phone:716-373-2716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056145183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist