Provider Demographics
NPI:1831378256
Name:AHMED, HEATHER LEE (RPH)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LEE
Last Name:AHMED
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 LAKEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW
Mailing Address - State:NY
Mailing Address - Zip Code:14085-9706
Mailing Address - Country:US
Mailing Address - Phone:716-627-5635
Mailing Address - Fax:716-627-5635
Practice Address - Street 1:355 ORCHARD PARK RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2634
Practice Address - Country:US
Practice Address - Phone:716-517-3003
Practice Address - Fax:716-517-3024
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046139183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist