Provider Demographics
NPI:1699948034
Name:MACKIEWICZ, CLAIRE BUCKLEY (RPH)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:BUCKLEY
Last Name:MACKIEWICZ
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 1:621 N STAR RD
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-9421
Mailing Address - Country:US
Mailing Address - Phone:716-652-7424
Mailing Address - Fax:716-537-2105
Practice Address - Street 1:19 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:NY
Practice Address - Zip Code:14080-9509
Practice Address - Country:US
Practice Address - Phone:716-537-2822
Practice Address - Fax:716-537-2105
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist