Provider Demographics
NPI:1962734723
Name:LOTANO, NICHOLAS WILLIAM SR (RPH)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:WILLIAM
Last Name:LOTANO
Suffix:SR
Gender:M
Credentials:RPH
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Mailing Address - Street 1:100 SARATOGA VILLAGE BLVD
Mailing Address - Street 2:SUITE 18-19
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-8469
Mailing Address - Country:US
Mailing Address - Phone:518-899-2002
Mailing Address - Fax:518-899-5489
Practice Address - Street 1:100 SARATOGA VILLAGE BLVD
Practice Address - Street 2:STE 18-19
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020-3737
Practice Address - Country:US
Practice Address - Phone:518-899-2002
Practice Address - Fax:518-899-5489
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
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Provider Licenses
StateLicense IDTaxonomies
NY040180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist