Provider Demographics
NPI:1124575105
Name:DUNLAP, RONALD (PHARMACIST)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:DUNLAP
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4694 JOHN MICHAEL WAY
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-1125
Mailing Address - Country:US
Mailing Address - Phone:702-219-6265
Mailing Address - Fax:
Practice Address - Street 1:349 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:716-827-8341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049520183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist