Provider Demographics
NPI:1871939256
Name:OESTERLE, BETHANY RUTH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:RUTH
Last Name:OESTERLE
Suffix:
Gender:F
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:PO BOX 1027
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14240-1027
Mailing Address - Country:US
Mailing Address - Phone:716-635-5000
Mailing Address - Fax:
Practice Address - Street 1:6363 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5855
Practice Address - Country:US
Practice Address - Phone:716-635-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist