Provider Demographics
NPI:1992985246
Name:POSSINGER, BRIAN (RPH)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:POSSINGER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 UNION RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1215
Mailing Address - Country:US
Mailing Address - Phone:716-677-4360
Mailing Address - Fax:716-677-6710
Practice Address - Street 1:3050 UNION RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1215
Practice Address - Country:US
Practice Address - Phone:716-677-4360
Practice Address - Fax:716-677-6710
Is Sole Proprietor?:No
Enumeration Date:2007-11-04
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00472808Medicaid