Individual
MS. DANIELA DETHOMASIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2161 FAIRPORT NINE MILE PT RD, FAIRPORT, NY 14450-8509
(585) 377-1196
Mailing address
113 MEADOWBROOK DR, SLINGERLANDS, NY 12159-2123
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
047543
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02799026
—
NY
Enumeration date
02/11/2008
Last updated
04/23/2008
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