Provider Demographics
NPI:1932421666
Name:PATEREK, DANIELLE PETRINA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:PETRINA
Last Name:PATEREK
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 1:36 CREEKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-9386
Mailing Address - Country:US
Mailing Address - Phone:716-684-3632
Mailing Address - Fax:
Practice Address - Street 1:5360 SOUTHWESTERN BLVD
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-3504
Practice Address - Country:US
Practice Address - Phone:716-646-1837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048108-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist