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Individual

MR. AUGUST LOUIS MAGNANTI JR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
405 ERIE BLVD W, ROME, NY 13440-4803
(315) 337-4120
Mailing address
405 ERIE BLVD. WEST, ROME, NY 13440-5739
(315) 339-1392

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
027910
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00584652
NY
Enumeration date
11/12/2007
Last updated
03/12/2010
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