Provider Demographics
NPI:1831300821
Name:LUNN, MICHELLE SUZANNE (RPH)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:SUZANNE
Last Name:LUNN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 HARD ROCK RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-9386
Mailing Address - Country:US
Mailing Address - Phone:585-872-9432
Mailing Address - Fax:
Practice Address - Street 1:2975 BRIGHTON HENRIETTA TL RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2787
Practice Address - Country:US
Practice Address - Phone:585-461-1314
Practice Address - Fax:585-292-5496
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048026183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist