Provider Demographics
NPI:1740509330
Name:GUELI, AMANDA ROSE
Entity type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:ROSE
Last Name:GUELI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 SOUTHWESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1230
Mailing Address - Country:US
Mailing Address - Phone:716-675-4958
Mailing Address - Fax:855-331-9007
Practice Address - Street 1:3201 SOUTHWESTERN BLVD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1230
Practice Address - Country:US
Practice Address - Phone:716-675-4958
Practice Address - Fax:855-331-9007
Is Sole Proprietor?:No
Enumeration Date:2010-05-22
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist