Provider Demographics
NPI:1871817015
Name:O'DONNELL, ALICE MARIE (RPH)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:MARIE
Last Name:O'DONNELL
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 1:260 ROYAL PKWY E
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6406
Mailing Address - Country:US
Mailing Address - Phone:716-634-7422
Mailing Address - Fax:
Practice Address - Street 1:7414 NIAGARA FALLS BLVD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-1720
Practice Address - Country:US
Practice Address - Phone:716-283-0370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist