Provider Demographics
NPI:1356615850
Name:COLANGELO, WILLIAM PAUL (PHARMACIST)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PAUL
Last Name:COLANGELO
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4892 EDGEWORTH DR
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-2107
Mailing Address - Country:US
Mailing Address - Phone:315-682-1619
Mailing Address - Fax:
Practice Address - Street 1:4800 BEAR RD
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-4604
Practice Address - Country:US
Practice Address - Phone:315-457-9946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist