Provider Demographics
NPI:1700262912
Name:OCCHINO, PHILIP (PHARMD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:OCCHINO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32331 N SCOTTSDALE
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1050 NIAGARA ST STE 110
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-2001
Practice Address - Country:US
Practice Address - Phone:716-423-2313
Practice Address - Fax:716-423-2329
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS021415183500000X
NYI064136183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist