National Provider Identifier

Michael Sundance Lake, PHARMD

Michael Sundance Lake, PHARMD is listed in the NPPES registry with a primary specialty of Pharmacist in Cheektowaga, NY and a listed phone number of (716) 892-8115.

NPI 1124452164Cheektowaga, NYPharmacist

Profile Overview

NPI
1124452164
Provider Type
Individual
Primary Specialty
Pharmacist
Enumeration Date
August 27, 2013
Last Updated
August 27, 2013

Practice Location

  • 2887 Harlem RD
  • Cheektowaga, NY 14225-3038

Phone: (716) 892-8115

Mailing Address

  • 211 Summer St
  • Apt 1
  • Buffalo, NY 14222-2218

Specialties

  • Pharmacist (183500000X)
Full Record
NPI
1124452164
Entity Type
Individual
Last Name
Lake
First Name
Michael
Middle Name
Sundance
Name Prefix
Dr.
Credential
PHARMD
Mailing Street Address
211 Summer St
Mailing Address Line 2
Apt 1
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14222-2218
Mailing Country
US
Mailing Phone
(716) 803-5564
Practice Street Address
2887 Harlem RD
Practice City
Cheektowaga
Practice State
NY
Practice ZIP Code
14225-3038
Practice Country
US
Practice Phone
(716) 892-8115
Practice Fax
(716) 892-6027
Enumeration Date
August 27, 2013
Last Updated
August 27, 2013
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Pharmacist (183500000X)