Provider Demographics
NPI:1932232204
Name:O'DONNELL, MELISSA M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:M
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8061 BREWERTON RD
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:NY
Mailing Address - Zip Code:13039
Mailing Address - Country:US
Mailing Address - Phone:315-698-2381
Mailing Address - Fax:315-698-2381
Practice Address - Street 1:8061 BREWERTON RD
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039
Practice Address - Country:US
Practice Address - Phone:315-698-2381
Practice Address - Fax:315-698-2381
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050373183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist