Provider Demographics
NPI:1790947745
Name:MACEVOY, MICHAEL STEVEN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:MACEVOY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7698 KERWIN RD
Mailing Address - Street 2:
Mailing Address - City:GASPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14067-9430
Mailing Address - Country:US
Mailing Address - Phone:716-983-8149
Mailing Address - Fax:
Practice Address - Street 1:7698 KERWIN RD
Practice Address - Street 2:
Practice Address - City:GASPORT
Practice Address - State:NY
Practice Address - Zip Code:14067-9430
Practice Address - Country:US
Practice Address - Phone:716-772-5057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0519081835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist