Individual
DR. DANIELLE RENEE HENNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2325 GRAND ISLAND BLVD, GRAND ISLAND, NY 14072-1819
(716) 773-1724
Mailing address
6725 CORTLAND DR, NORTH TONAWANDA, NY 14120-9651
(716) 908-5950
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
050405
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01083765
—
NY
Enumeration date
12/11/2007
Last updated
12/11/2007
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