Provider Demographics
NPI:1962548347
Name:MINEO, NANCY (RPH)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MINEO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:NICOLIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:35 RUMSON RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-3045
Mailing Address - Country:US
Mailing Address - Phone:716-691-6645
Mailing Address - Fax:
Practice Address - Street 1:20 LAWRENCE BELL DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7074
Practice Address - Country:US
Practice Address - Phone:716-204-9060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY28742183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist