Individual
BRENT NELSON LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
899 MAIN ST, BUFFALO, NY 14203-1109
(716) 885-2833
(716) 504-5657
Mailing address
899 MAIN ST, BUFFALO, NY 14203-1109
(716) 885-2833
(716) 504-5657
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
038792
NY
Other
Enumeration date
02/01/2010
Last updated
02/01/2010
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