Provider Demographics
NPI:1174117816
Name:DONNARUMMA, DEBRA ANN (RPH)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:DONNARUMMA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9722 COBBLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-2428
Mailing Address - Country:US
Mailing Address - Phone:716-308-7103
Mailing Address - Fax:
Practice Address - Street 1:9722 COBBLESTONE DR
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-2428
Practice Address - Country:US
Practice Address - Phone:716-308-7103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist