Provider Demographics
NPI:1952425407
Name:GARTZ, WENDY S (RPH)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:S
Last Name:GARTZ
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 1:93 AVON RD
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-8403
Mailing Address - Country:US
Mailing Address - Phone:716-837-6704
Mailing Address - Fax:
Practice Address - Street 1:2585 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2023
Practice Address - Country:US
Practice Address - Phone:716-862-0511
Practice Address - Fax:716-862-9838
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2008-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist