Provider Demographics
NPI:1831159573
Name:RUTOWSKI, JOSEPH A (RPH)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:RUTOWSKI
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 1:211 COLUMBIA DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6967
Mailing Address - Country:US
Mailing Address - Phone:716-632-7864
Mailing Address - Fax:
Practice Address - Street 1:1031 CLEVELAND DR
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-1221
Practice Address - Country:US
Practice Address - Phone:716-632-4888
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist