Provider Demographics
NPI:1538757729
Name:HARVEY, CHRISTOPHER JEREMY (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JEREMY
Last Name:HARVEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14223-2527
Mailing Address - Country:US
Mailing Address - Phone:585-880-7461
Mailing Address - Fax:
Practice Address - Street 1:4923 LAKE SHORE RD
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-5662
Practice Address - Country:US
Practice Address - Phone:716-627-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist