Provider Demographics
NPI:1922131176
Name:FLEMMING, JAY (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:
Last Name:FLEMMING
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 LONDONDERRY LN
Mailing Address - Street 2:
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1174
Mailing Address - Country:US
Mailing Address - Phone:716-636-1182
Mailing Address - Fax:716-631-2961
Practice Address - Street 1:480 EVANS ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5670
Practice Address - Country:US
Practice Address - Phone:716-631-2147
Practice Address - Fax:716-631-2961
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046245183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist