Provider Demographics
NPI:1356521686
Name:PORTER, DEBRA LEY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:LEY
Last Name:PORTER
Suffix:
Gender:F
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 1:449 FAIRMONT AVE
Mailing Address - Street 2:
Mailing Address - City:N TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2915
Mailing Address - Country:US
Mailing Address - Phone:716-695-6204
Mailing Address - Fax:
Practice Address - Street 1:345 AMHERST ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-2809
Practice Address - Country:US
Practice Address - Phone:716-515-2190
Practice Address - Fax:716-515-2400
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-03
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist