Provider Demographics
NPI:1760705842
Name:RIBAUDO, MICHELLE JOY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:JOY
Last Name:RIBAUDO
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 1:5 W MILL ST
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:16350-1517
Mailing Address - Country:US
Mailing Address - Phone:716-450-9526
Mailing Address - Fax:
Practice Address - Street 1:19 S MAIN ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-6636
Practice Address - Country:US
Practice Address - Phone:716-488-0778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054331183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist