Provider Demographics
NPI:1962703413
Name:VINK, TIMOTHY J (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:J
Last Name:VINK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3569 S NEWSTEAD RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:NY
Mailing Address - Zip Code:14001-9582
Mailing Address - Country:US
Mailing Address - Phone:585-750-8889
Mailing Address - Fax:
Practice Address - Street 1:1083 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-1635
Practice Address - Country:US
Practice Address - Phone:716-862-2449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2013-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053685-11835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist