Provider Demographics
NPI:1215550389
Name:LANZA, STEPHANIE B (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:B
Last Name:LANZA
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 1:219 POTTERS RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14220-2416
Mailing Address - Country:US
Mailing Address - Phone:716-289-3485
Mailing Address - Fax:
Practice Address - Street 1:9217 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-1931
Practice Address - Country:US
Practice Address - Phone:716-634-7901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-25
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067116183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist