Provider Demographics
NPI:1811005911
Name:GALLETTA, VINCENT ANGELO (MS, RPH)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:ANGELO
Last Name:GALLETTA
Suffix:
Gender:M
Credentials:MS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 DUTCHMILL DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-1754
Mailing Address - Country:US
Mailing Address - Phone:716-688-9573
Mailing Address - Fax:716-832-5893
Practice Address - Street 1:20 LAWRENCE BELL DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7074
Practice Address - Country:US
Practice Address - Phone:716-204-9060
Practice Address - Fax:716-204-9061
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY28676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist