Provider Demographics
NPI:1447439823
Name:MARTINO, TODD EDWARD (PHARMD/RPH)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:EDWARD
Last Name:MARTINO
Suffix:
Gender:M
Credentials:PHARMD/RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3854 WILDWING DR
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-1384
Mailing Address - Country:US
Mailing Address - Phone:716-807-2394
Mailing Address - Fax:
Practice Address - Street 1:150 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-1001
Practice Address - Country:US
Practice Address - Phone:716-693-6400
Practice Address - Fax:176-693-5048
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048283183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist